Nakakita Baku, Abiko Kaoru, Mikami Yoshiki, Kido Aki, Baba Tsukasa, Yoshioka Yumiko, Yamaguchi Ken, Matsumura Noriomi, Konishi Ikuo
Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Pathol Int. 2014 Nov;64(11):576-80. doi: 10.1111/pin.12218. Epub 2014 Oct 31.
A uterus-like mass is an extrauterine mass with a cavity lined by endometrial tissue and a smooth muscle layer resembling the uterine corpus. It is a rare condition of unknown histogenesis. Herein, we describe a case of clear cell carcinoma arising from a uterus-like mass located in the retroperitoneal space. The patient, a 67-year old nulliparous woman, had been followed with the diagnosis of an ovarian endometriotic cyst for 14 years until ultrasonography and magnetic resonance imaging (MRI) demonstrated an enlargement of the cystic mass with a thickened irregular wall. Suspicion of malignant transformation prompted us to excise the lesion. At laparotomy, the uterus and right ovary appeared normal, and a mass measuring 8 cm was identified in the retroperitoneal space without any connection to the uterus. Grossly, the removed mass was composed of a cyst filled with blackish-brownish fluid and a thick wall resembling uterine myometrium. Microscopically, endometrial tissue inside the cyst, which was diffusely lined by clear cell carcinoma, was identified. Although the histogenesis of a uterus-like mass remains unclear, this case indicates that malignant tumors may occur from a uterus-like mass through the pathway similar to the carcinogenesis of endometriosis-related ovarian neoplasms.
子宫样肿物是一种子宫外肿物，其腔隙内衬有子宫内膜组织，并有一层类似于子宫体的平滑肌层。它是一种组织发生不明的罕见病症。在此，我们描述一例起源于腹膜后间隙子宫样肿物的透明细胞癌病例。该患者为一名67岁未生育女性，诊断为卵巢子宫内膜异位囊肿并随访了14年，直至超声检查和磁共振成像（MRI）显示囊性肿物增大且壁增厚不规则。怀疑发生恶变促使我们切除该病变。剖腹手术时，子宫和右侧卵巢外观正常，在腹膜后间隙发现一个8厘米大小的肿物，与子宫无任何连接。大体上，切除的肿物由一个充满黑褐色液体的囊肿和一层类似子宫肌层的厚壁组成。显微镜下，囊肿内可见子宫内膜组织，其被透明细胞癌弥漫性内衬。尽管子宫样肿物的组织发生仍不清楚，但该病例表明，恶性肿瘤可能通过类似于子宫内膜异位症相关卵巢肿瘤的致癌途径从子宫样肿物发生。
