Gaballa Khaled, Cicero Carla, Gallotta Valerio, Zannoni Gianfranco, Scambia Giovanni
Surgical Oncology, Oncology Center Mansoura University, Mansoura, Egypt.
Gynecologic Oncology, Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
J Egypt Natl Canc Inst. 2018 Jun;30(2):81-83. doi: 10.1016/j.jnci.2018.04.003. Epub 2018 May 17.
We discuss the diagnosis and the management of endometrial carcinoma in a single horn of bicornuate uterus in a 64-year-old woman as a case report. The case underwent laparoscopic radical hysterectomy and bilateral iliac lymphadenectomy. The gross examination of the uterus revealed a bicornuate uterus with a greater horn of 12 × 9 × 8 cm and a smaller horn of 10 × 3 cm. The cavity of the greater horn showed a neoplastic growth of 10 cm with infiltration of about 1,8 cm of the myometrium from whole thickness of 1.9 cm. while the other horn was free of tumor tissue. The microscopic examination of the uterus revealed G2 endometrioid adenocarcinoma of the endometrium of the greater horn with infiltration of more than 50% of the myometrium. In the presence of bicornuate uterus, a bilateral endometrial biopsy should be performed in order to reduce the risk of delayed or missed diagnosis. The management of a case of bicornuate unicollis uterus with endometrial carcinoma in only one horn is the same as patients with endometrial cancer in single uterus and depends mainly on stage and histological grade of the tumor. The possibility of existence of a separate uterine cavity should always be considered when endometrial cancer is clinically suspected but pathology fails to confirm the diagnosis. This points out the importance of a careful physical examination and radiographic evaluation in such cases.
我们报告一例64岁女性双角子宫单角子宫内膜癌的诊断及治疗情况。该病例接受了腹腔镜根治性子宫切除术及双侧髂淋巴结清扫术。子宫大体检查显示为双角子宫,大角为12×9×8cm,小角为10×3cm。大角宫腔内见一10cm的肿瘤生长,侵犯肌层厚度1.9cm中的1.8cm,而另一角未见肿瘤组织。子宫显微镜检查显示大角子宫内膜为G2级子宫内膜样腺癌,肌层浸润超过50%。对于双角子宫,应进行双侧子宫内膜活检以降低延迟诊断或漏诊风险。单角双子宫且仅一个角发生子宫内膜癌的病例处理方式与单子宫子宫内膜癌患者相同,主要取决于肿瘤分期及组织学分级。当临床怀疑子宫内膜癌但病理未能确诊时,应始终考虑存在独立子宫腔的可能性。这凸显了此类病例中仔细体格检查及影像学评估的重要性。