Marchand Eva, Hequet Delphine, Thoury Anne, Barranger Emmanuel
Department of Gynecology, Lariboisiere Hospital, Paris, France.
BMJ Case Rep. 2013 Aug 26;2013:007730. doi: 10.1136/bcr-2012-007730.
A 63-year-old woman with no medical history underwent an abdominal surgery with hysterectomy and bilateral salpingo-oophorectomy for a 10 cm peritoneal cyst with increased cancer antigene-125. A large suspicious tumour of the Douglas space, with contact to the uterus and the rectal wall was described. The rest of the exploration was normal, specially the rest of the peritoneum. Histopathology revealed a malignant transformation of a superficial peritoneal endometriosis. Secondary surgery was thus completed by laparoscopy with bilateral pelvic and para-aortic lymph node dissections, omentectomy and multiple peritoneal biopsies. All staging samples were free of cancer; therefore no complementary therapy was administered. After 18 months of follow-up, consisting of clinical examination and pelvis magnetic resonance imaging every 6 months, we did not observe any recurrence. Malignant transformation of superficial peritoneal endometriosis is a rare disease and surgical management seems to be the main treatment.
一名无病史的63岁女性因一个10厘米的腹膜囊肿且癌抗原125升高，接受了包括子宫切除术和双侧输卵管卵巢切除术的腹部手术。术中描述Douglas腔有一个大的可疑肿瘤，与子宫和直肠壁相连。其余探查未见异常，特别是其余腹膜未见异常。组织病理学显示为浅表性腹膜子宫内膜异位症恶变。因此，通过腹腔镜完成了二次手术，包括双侧盆腔及腹主动脉旁淋巴结清扫、大网膜切除术和多处腹膜活检。所有分期样本均无癌细胞；因此未给予辅助治疗。经过18个月的随访，包括每6个月进行一次临床检查和盆腔磁共振成像检查，我们未观察到任何复发情况。浅表性腹膜子宫内膜异位症恶变是一种罕见疾病，手术治疗似乎是主要治疗方法。
