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因电子粉碎术导致早期低级别子宫内膜样间质肉瘤盆腔内播散

Intrapelvic dissemination of early low-grade endometrioid stromal sarcoma due to electronic morcellation.

作者信息

Choo Kyoung-Ja, Lee Hyun Joo, Lee Tae Sung, Kim Ju Hyun, Koh Suk Bong, Choi Youn Seok

机构信息

Department of Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea.

出版信息

Obstet Gynecol Sci. 2015 Sep;58(5):414-7. doi: 10.5468/ogs.2015.58.5.414. Epub 2015 Sep 22.

DOI:10.5468/ogs.2015.58.5.414
PMID:26430669
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4588849/
Abstract

Endometrioid stromal sarcoma is a rare malignancy that originates from mesenchymal cells. It is classified into low-grade endometrioid stromal sarcoma (LGESS) and high-grade endometrioid stromal sarcoma. Ultrasonographic findings of LGESS resemble those of submucosal myomas, leading to the possible preoperative misdiagnosis of LGESS as uterine leiomyoma. Electronic morcellation during laparoscopic surgery in women with LGESS can result in iatrogenic intraabdominal dissemination and a poorer prognosis. Here, we report a patient with LGESS who underwent a supracervical hysterectomy and electronic morcellation for a presumed myoma in another hospital. Disseminated metastatic lesions of LGESS in the posterior cul-de-sac and rectal serosal surface were absent on primary surgery, but found during reexploration. In conclusion, when LGESS is found incidentally following previous morcellation during laparoscopic surgery for presumed benign uterine disease, we highly recommend surgical reexploration, even when there is no evidence of a metastatic lesion in imaging studies.

摘要

子宫内膜样间质肉瘤是一种起源于间充质细胞的罕见恶性肿瘤。它分为低级别子宫内膜样间质肉瘤（LGESS）和高级别子宫内膜样间质肉瘤。LGESS的超声检查结果与黏膜下肌瘤相似，这可能导致术前将LGESS误诊为子宫平滑肌瘤。LGESS女性患者在腹腔镜手术中进行电子粉碎术可导致医源性腹腔内播散并预后较差。在此，我们报告一名LGESS患者，其在另一家医院因疑似肌瘤接受了次全子宫切除术和电子粉碎术。初次手术时后穹窿和直肠浆膜表面未发现LGESS的播散性转移病灶，但在再次探查时发现了。总之，当在腹腔镜手术治疗疑似良性子宫疾病时先前已进行粉碎术而偶然发现LGESS时，即使影像学检查没有转移病灶的证据，我们强烈建议进行手术再次探查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d599/4588849/8a8cfeeb2aac/ogs-58-414-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d599/4588849/14e851b06d45/ogs-58-414-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d599/4588849/8a8cfeeb2aac/ogs-58-414-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d599/4588849/14e851b06d45/ogs-58-414-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d599/4588849/8a8cfeeb2aac/ogs-58-414-g002.jpg

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本文引用的文献

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