Gao H J, Zhou W, Zhang X F, Zhou C Y, Qian J H
Hangzhou First People's Hospital, Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.
Eur J Gynaecol Oncol. 2013;34(4):362-7.
To report the first case of a uterine gestational choriocarcinoma coexisting with an endometrial carcinoma (EC) and to discuss its possible pathogenesis.
All tissues were examined histologically and monoclonal antibodies were used to evaluate the expression of HCG, HPL, P53, PTEN, and ER. Genotyping was performed on DNA extracted from the freshly dissected choriocarcinoma and the paraffin-embedded endometrial carcinoma along with parental blood DNA using multiplex STR-PCR at 16 loci.
Histology identified two distinct tumors: a uterine tumor containing cytotrophoblastic and syncytiotrophoblastic cells and a second distinct neoplasm composed of adenocarcinoma resembling endometrioid and mucinous adenocarcinoma. Genotyping of the choriocarcinoma revealed alleles from both the patient and her husband and was classified as biparental in origin. The endometrial adenocarcinoma contained only maternal alleles and was thus classified as maternal in origin.
This is the first description of the simultaneous diagnosis of a uterine gestational choriocarcinoma and an EC within the same patient. DNA genotyping and immunohistochemistry are valuable tools in distinguishing the different origins of coexisting tumors.
报告首例子宫妊娠性绒毛膜癌与子宫内膜癌（EC）并存的病例，并探讨其可能的发病机制。
对所有组织进行组织学检查，使用单克隆抗体评估HCG、HPL、P53、PTEN和ER的表达。对从新鲜解剖的绒毛膜癌和石蜡包埋的子宫内膜癌中提取的DNA以及亲本血液DNA进行16个位点的多重STR-PCR基因分型。
组织学检查发现两种不同的肿瘤：一种子宫肿瘤含有细胞滋养层细胞和合体滋养层细胞，另一种不同的肿瘤由类似子宫内膜样腺癌和黏液腺癌的腺癌组成。绒毛膜癌的基因分型显示来自患者及其丈夫的等位基因，起源被分类为双亲性。子宫内膜腺癌仅含有母系等位基因，因此起源被分类为母系性。
这是同一患者同时诊断出子宫妊娠性绒毛膜癌和EC的首次描述。DNA基因分型和免疫组织化学是区分并存肿瘤不同起源的有价值工具。
