Obata Koshiro, Ikoma Naoko, Oomura Gen, Inoue Yoshiki
Department of Obstetrics and Gynecology, Kinki University School of Medicine, Nara Hospital, Nara, Japan.
J Obstet Gynaecol Res. 2013 Jan;39(1):455-61. doi: 10.1111/j.1447-0756.2012.01964.x. Epub 2012 Jul 29.
Umbilical endometriosis is a very rare condition, and as far as we are aware, there have been no reported cases of its malignant transformation. Here, we report a case of clear cell adenocarcinoma arising from umbilical endometriosis in a 60-year-old woman who underwent hysterectomy for a uterine myoma at the age of 38, and who denied cyclic bleeding at the site of an umbilical cutaneous nodule correlating with menses until the age of 48. An umbilical tumor (3 cm diameter) was identified by magnetic resonance imaging and an abnormal accumulation was found only at the umbilical lesion by positron emission tomography examination. We observed endometriosis adjacent to the clear cell adenocarcinoma and transformation to carcinoma from endometriosis at the umbilical lesion histopathologically. Clear cell adenocarcinoma of the umbilicus was thought to have arisen from endometriosis; it expressed HER-2 protein and showed strong mesothelial characteristics immunohistochemically.
脐部子宫内膜异位症是一种非常罕见的疾病，据我们所知，尚无其恶变的报道病例。在此，我们报告一例60岁女性脐部子宫内膜异位症继发透明细胞腺癌的病例。该患者38岁时因子宫肌瘤接受子宫切除术，48岁之前否认脐部皮肤结节处有与月经周期相关的周期性出血。通过磁共振成像发现一个直径3 cm的脐部肿瘤，正电子发射断层扫描检查仅在脐部病变处发现异常聚集。组织病理学检查发现透明细胞腺癌旁有子宫内膜异位症，且脐部病变处存在子宫内膜异位症向癌的转变。脐部透明细胞腺癌被认为起源于子宫内膜异位症；免疫组化显示其表达HER-2蛋白并具有较强的间皮特征。
