剖宫产子宫切除术时因胎盘粘连严重而偶然发现的平滑肌肉瘤。
Incidental leiomyosarcoma found at the time of cesarean hysterectomy for morbidly adherent placenta.
作者信息
Hand Lauren C, Gimovsky Alexis C, Chan Joanna S Y, Rosenblum Norman G, Kim Christine H
机构信息
Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 833 Chestnut Street, Concourse Level, Philadelphia, PA 19107, USA.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 833 Chestnut Street, Concourse Level, Philadelphia, PA 19107, USA.
出版信息
Gynecol Oncol Rep. 2017 Apr 29;20:127-130. doi: 10.1016/j.gore.2017.04.007. eCollection 2017 May.
BACKGROUND
Incidental leiomyosarcoma (LMS) is a rare diagnosis in pregnancy or in the puerperium. To our knowledge, this is the first case reported in the literature of incidental LMS after cesarean hysterectomy for morbidly adherent placenta.
CASE
We present a case of a cesarean hysterectomy performed for a suspected morbidly adherent placenta in a patient with three prior cesarean deliveries, an anterior placenta previa and a fundal fibroid. Subsequent pathology identified a LMS on final specimen. The patient declined bilateral oophorectomy and removal of her remaining cervix. No chemotherapy or radiation was given for her presumed stage IB disease.
CONCLUSION
An incidental finding of a LMS is infrequent; the risk of recurrence is > 50% even if the sarcoma is removed in its entirety.
背景
妊娠或产褥期偶然发现的平滑肌肉瘤（LMS）是一种罕见的诊断。据我们所知，这是文献中首次报道的因胎盘植入而行剖宫产子宫切除术后偶然发现LMS的病例。
病例
我们报告一例为疑似胎盘植入而行剖宫产子宫切除术的病例，患者既往有三次剖宫产史、前置胎盘和子宫底部肌瘤。后续病理检查在最终标本中发现了LMS。患者拒绝双侧卵巢切除术及剩余宫颈切除术。对于其假定的ⅠB期疾病，未给予化疗或放疗。
结论
偶然发现LMS的情况并不常见；即使肉瘤被完整切除，复发风险仍>50%。
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