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一名15岁肥胖患者,伴有持续性子宫出血,患有子宫内膜癌。

Endometrial carcinoma in a 15-year-old obese patient with persistent uterine bleeding.

作者信息

Liu Guoyan, Wang Yingmei, Zhang Xuhong, Yuan Bibo, Han Cha, Xue Fengxia

机构信息

Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital , Tianjin , China.

出版信息

Gynecol Endocrinol. 2014 Apr;30(4):277-9. doi: 10.3109/09513590.2013.875156. Epub 2014 Jan 23.

Abstract

Endometrial carcinoma is the most common malignancy of the upper female genital tract but is rare in teenagers. Here, we report the case of a 15-year-old, nulliparous, morbidly obese female with complaints of asthenia and menometrorrhagia lasting for six months. On examination, the patient had an enlarged uterus approximately 14 gestational weeks in size, and ultrasound revealed an intrauterine mass and polycystic ovaries. An endometrial biopsy performed during hysteroscopy revealed endometrioid adenocarcinoma, and magnetic resonance imaging showed myometrial invasion. The patient underwent a laparotomy involving total abdominal hysterectomy, right salpingo-oophorectomy, wedge-shape dissection of the left ovary, and pelvic and para-aortic lymphadenectomy. We analyze the pathogenesis of endometrial carcinoma in this case and discuss the risk factors for endometrial carcinoma, especially in young women. Gynecologists should be vigilant for persistent abnormal uterine bleeding and other signs of endometrial carcinoma in young women, especially those who have risk factors for the disease.

摘要

子宫内膜癌是女性上生殖道最常见的恶性肿瘤,但在青少年中较为罕见。在此,我们报告一例15岁、未生育、病态肥胖的女性病例,该患者主诉乏力和月经过多持续6个月。检查时,患者子宫增大,约14孕周大小,超声显示宫腔内肿物及多囊卵巢。宫腔镜检查时进行的子宫内膜活检显示为子宫内膜样腺癌,磁共振成像显示肌层浸润。患者接受了剖腹手术,包括全腹子宫切除术、右侧输卵管卵巢切除术、左侧卵巢楔形切除术以及盆腔和腹主动脉旁淋巴结切除术。我们分析了该病例中子宫内膜癌的发病机制,并讨论了子宫内膜癌的危险因素,尤其是年轻女性中的危险因素。妇科医生应对年轻女性中持续的异常子宫出血及其他子宫内膜癌迹象保持警惕,尤其是那些具有该病危险因素的女性。

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