Grigoriadis C, Androutsopoulos G, Zygouris D, Arnogiannaki N, Terzakis E
Second Department of Gynaecology, St. Savvas Anticancer-Oncologic Hospital, Athens, Greece.
Eur J Gynaecol Oncol. 2012;33(6):666-8.
Synchronous primary endometrial and ovarian cancers are relatively uncommon in general population. The etiology and pathogenesis of this phenomenon remains unclear. The authors' aim was to present a case of synchronous squamous cell carcinoma of the endometrium and endometrioid adenocarcinoma of the ovary and review current literature.
The patient, a 64-year-old, nulliparous postmenopausal Greek woman presented with a complaint of abdominal pain and abnormal uterine bleeding. Preoperative computer tomography (CT) of the abdomen and pelvis, and abdominal ultrasound (U/S) revealed an intra-abdominal three cm mass with solid components between the left ovary and small bowel. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH+BS), total omentectomy, pelvic and para-aortic lymph node dissection, and removal of the implant at the serosa of small bowel. Histopathology revealed Stage IA endometrial cancer squamous type and Stage IIIC ovarian cancer of endometrioid-type. Postoperatively the patient underwent adjuvant chemotherapy and radiotherapy. Follow-up of 22 months after initial surgery revealed no evidence of recurrence.
The reason for better median overall survival of patients with synchronous primary endometrial and ovarian cancers is not intuitively obvious. Perhaps favourable clinical outcome may be related with the detection of patients at early stage and low-grade disease with an indolent growth rate.
同步性原发性子宫内膜癌和卵巢癌在普通人群中相对少见。这种现象的病因和发病机制仍不清楚。作者的目的是报告一例同步性子宫内膜鳞状细胞癌和卵巢子宫内膜样腺癌病例,并复习当前文献。
患者为一名64岁未育绝经后希腊女性,主诉腹痛和子宫异常出血。术前腹部和盆腔计算机断层扫描(CT)及腹部超声(U/S)显示左卵巢和小肠之间有一个3厘米的腹腔内实性肿块。患者接受了全腹子宫切除术加双侧输卵管卵巢切除术(TAH+BS)、全大网膜切除术、盆腔和腹主动脉旁淋巴结清扫术以及小肠浆膜面肿物切除术。组织病理学检查显示为IA期子宫内膜鳞状细胞癌和IIIC期子宫内膜样卵巢癌。术后患者接受了辅助化疗和放疗。初次手术后22个月的随访未发现复发迹象。
同步性原发性子宫内膜癌和卵巢癌患者中位总生存期较好的原因并不直观明显。也许良好的临床结局可能与早期发现患者以及疾病分级低、生长缓慢有关。