Masuyama Hisashi, Haraga Junko, Nishida Takashi, Ogawa Chikako, Kusumoto Tomoyuki, Nakamura Keiichiro, Seki Noriko, Yanai Hiroyuki, Hiramatsu Yuji
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Department of Pathology, Okayama University Hospital, Okayama 700-8558, Japan.
Mol Clin Oncol. 2016 Apr;4(4):563-566. doi: 10.3892/mco.2016.770. Epub 2016 Feb 5.
Collision tumors, which are characterized by the coexistence of two or more completely distinct and independent tumors in the uterine corpus, are very rare. A collision tumor is mainly composed of two distinct tumor types, epithelial and mesenchymal. To the best of our knowledge, there has only been a single case in which a choriocarcinoma with an endometrial carcinoma were coexistent but histologically distinct. We herein report the first case of a collision tumor in a 52-year-old woman, with a history of two pregnancies and two deliveries. The collision tumor was composed of three histologically distinct neoplasms in the uterine corpus, namely an endometrioid carcinoma, an undifferentiated carcinoma and a choriocarcinoma. The patient underwent hysterectomy, bilateral adnexectomy and pelvic lymph node dissection, followed by six cycles of adjuvant chemotherapy with paclitaxel/carboplatin due to the high risk of endometrial cancer, and an additional five cycles of chemotherapy with methotrexate, as the β-human chorionic gonadotropin level was beyond the normal range. Following adjuvant chemotherapy, the tumor markers were within normal limits and no relapses of the cancer have been observed during 1 year of follow-up. Diagnosing a collision tumor prior to surgery is difficult if the neoplasms are in close proximity, or if one of the tumors predominates. Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.
碰撞瘤是指子宫体中存在两种或更多完全不同且独立的肿瘤，极为罕见。碰撞瘤主要由上皮和间叶两种不同的肿瘤类型组成。据我们所知，仅有一例绒毛膜癌与子宫内膜癌并存但组织学上不同的病例。我们在此报告首例52岁有两次妊娠和两次分娩史女性的碰撞瘤病例。该碰撞瘤由子宫体中三种组织学上不同的肿瘤组成，即子宫内膜样癌、未分化癌和绒毛膜癌。患者接受了子宫切除术、双侧附件切除术和盆腔淋巴结清扫术，由于子宫内膜癌风险高，随后进行了六个周期的紫杉醇/卡铂辅助化疗，又因β-人绒毛膜促性腺激素水平超出正常范围，额外进行了五个周期的甲氨蝶呤化疗。辅助化疗后，肿瘤标志物在正常范围内，随访1年未观察到癌症复发。如果肿瘤紧邻或其中一种肿瘤占主导，术前诊断碰撞瘤很困难。仔细的病理检查对于准确诊断碰撞瘤中的肿瘤并确保适当的管理和良好预后至关重要。
