Baba Akira, Yamazoe Shinji, Dogru Murat, Ogawa Mariko, Takamatsu Kiyoshi, Miyauchi Jun
Department of Radiology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
J Obstet Gynaecol Res. 2016 Feb;42(2):217-23. doi: 10.1111/jog.12866. Epub 2015 Nov 4.
Ovaries are the primary sites of cancerous disease that is derived from endometriosis. Uterine cancer originating from endometriosis is very rare. The most frequent histological subtype of cancer derived from endometriosis is endometrioid adenocarcinoma, a subtype of clear cell carcinoma which is exceedingly rare. We report a case of a 40-year-old Japanese woman with a six year history of uterine leiomyoma. The patient was clinically and radiologically suspected to have degenerative uterine myoma with a possible malignant association and underwent a transabdominal total hysterectomy. Histopathological examination of the specimens revealed clear cell adenocarcinoma arising from the adenomyotic cyst. A literature review of clear cell adenocarcinomas arising from uterine adenomyotic cysts (cystic adenomyosis), emphasizes the clinically and radiologically important features of this very rare entity. Clear cell carcinoma association should be suspected in patients who are under follow-up for uterine myomas and present with cystic uterine changes with solid component on magnetic resonance imaging or computed tomography scans.
卵巢是源自子宫内膜异位症的癌性疾病的主要发病部位。源自子宫内膜异位症的子宫癌非常罕见。源自子宫内膜异位症的癌症最常见的组织学亚型是子宫内膜样腺癌，而透明细胞癌亚型极为罕见。我们报告一例40岁日本女性病例，该患者有六年子宫平滑肌瘤病史。临床和影像学检查怀疑该患者患有变性子宫肌瘤且可能伴有恶性病变，遂行经腹全子宫切除术。标本的组织病理学检查显示，腺肌病囊肿发生了透明细胞腺癌。对源自子宫腺肌病囊肿（囊性腺肌病）的透明细胞腺癌的文献综述强调了这种非常罕见疾病在临床和影像学上的重要特征。对于因子宫肌瘤接受随访且磁共振成像或计算机断层扫描显示子宫有囊性改变并伴有实性成分的患者，应怀疑存在透明细胞癌关联。
