Shekhar Shashank, Thakur Sita, Singh Kamal, Chander Bal
Department of Obstetrics & Gynecology, Dr RPGMC Tanda, Kangra, Himachal Pradesh, India.
BMJ Case Rep. 2013 Jan 11;2013:bcr2012007868. doi: 10.1136/bcr-2012-007868.
Synchronously occurring primary gynecological malignancies are rare, and most commonly reported synchronous female genital malignancies are ovarian and endometrial. It is postulated that the extended Mullerian system, comprising the ovarian epithelium, fallopian tube, uterine corpus and cervix, may respond as a single morphological unit to a carcinogenic process, thus producing primary tumours at above-mentioned sites in varying combinations. We are reporting for the first time, an unusual occurrence of synchronous papillary serous cystadenocarcinoma of the ovary and squamous cell carcinoma of lower vagina. Clinical implications of this case along with the multicentric concept of tumourigenesis and diagnosis of synchronous female genital malignancies are briefly discussed. Index case is probably a chance occurrence, as it cannot be explained by the current concepts of multicentric tumourogenesis in the female genital tract. Nonetheless, further research is warranted to explain simultaneous tumourogenesis in embryologically different tissues.
同步发生的原发性妇科恶性肿瘤较为罕见，最常报道的同步性女性生殖器恶性肿瘤是卵巢和子宫内膜的。据推测，由卵巢上皮、输卵管、子宫体和宫颈组成的广义苗勒系统可能作为一个单一的形态学单位对致癌过程做出反应，从而以上述不同组合在这些部位产生原发性肿瘤。我们首次报道了一例罕见的卵巢乳头状浆液性囊腺癌与阴道下段鳞状细胞癌同步发生的病例。本文简要讨论了该病例的临床意义以及肿瘤发生的多中心概念和同步性女性生殖器恶性肿瘤的诊断。索引病例可能是偶然发生的，因为目前女性生殖道多中心肿瘤发生的概念无法解释这一现象。尽管如此，仍有必要进行进一步的研究以解释胚胎学上不同组织中肿瘤的同时发生。
