Department of Obstetrics and Gynecology, Toho University School of Medicine, Ohashi Medical Center, Ohashi, Meguro-ku, Tokyo, Japan.
J Minim Invasive Gynecol. 2011 Mar-Apr;18(2):257-61. doi: 10.1016/j.jmig.2010.11.009.
Adenomatoid tumors are rare benign mesothelial tumors of the genital tract, and only a few cases of uterine adenomatoid tumors treated at laparoscopic surgery have been reported. Herein is reported the case of a laparoscopically resected uterine adenomatoid tumor with coexisting endometriosis. A 34-year-old nulliparous woman with suspected uterine fibroma and endometrial cysts underwent laparoscopic surgery in which both the uterine tumor and the endometrial cysts were enucleated. Enucleation of the uterine tumor was difficult, and, therefore, the border between the tumor and normal myometrium was divided using a harmonic scalpel for tumor resection. Microscopic examination of the tumor showed irregularly proliferating smooth muscle cells and many round hiatuses lined by epithelial-like cells. These epithelial-like cells were immunohistochemically positive for mesothelin and podoplanin, and negative for CD34, which suggests that the tumor was an adenomatoid tumor. This may be the fourth reported case of an adenomatoid tumor resected using the laparoscopic approach.
腺肌瘤样肿瘤是生殖道罕见的良性间皮瘤，仅报道过少数几例经腹腔镜手术治疗的子宫腺肌瘤样肿瘤病例。本文报道了 1 例经腹腔镜切除的合并子宫内膜异位症的子宫腺肌瘤样肿瘤病例。1 名 34 岁未育妇女因疑似子宫肌瘤和子宫内膜囊肿而行腹腔镜手术，术中同时剔除了子宫肿瘤和子宫内膜囊肿。剔除子宫肿瘤较为困难，因此使用超声刀在肿瘤与正常子宫肌层之间划界以进行肿瘤切除。肿瘤的显微镜检查显示平滑肌细胞不规则增生，有许多由上皮样细胞排列的圆形间隙。这些上皮样细胞免疫组化染色 Mesothelin 和 podoplanin 阳性，CD34 阴性，提示肿瘤为腺肌瘤样肿瘤。这可能是第四例经腹腔镜切除的腺肌瘤样肿瘤病例。
