Hara Takeya, Miyoshi Ai, Kamei Yuji, Wakui Nao, Fujishiro Akiko, Kanao Serika, Naoi Hirokazu, Otsuka Hirofumi, Yokoi Takeshi
Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan.
Case Rep Obstet Gynecol. 2018 Jun 4;2018:7591769. doi: 10.1155/2018/7591769. eCollection 2018.
Uterine mesenchymal tumors other than leiomyosarcoma, carcinosarcoma, and endometrial stromal sarcomas are extremely uncommon. We describe a case of epithelioid angiosarcoma of the uterus and review previous literature on such rare tumors. A 48-year-old woman presented with a 1-year history of abdominal fullness and 10kg weight loss. Pelvic magnetic resonance imaging (MRI) revealed a huge (30×18cm) uterus accompanied by degeneration and necrosis. She underwent supracervical hysterectomy and right salpingo-oophorectomy. We postoperatively diagnosed the mass as an epithelioid angiosarcoma arising from a leiomyoma. Vasodilatation was observed within the range of 2 cm × several mm in the leiomyoma, and proliferation of atypical cells was observed covering the surface of the luminal side. The tumor showed a partly fine vascular structure and was associated with obvious nuclear atypia and mitotic figures. She received 6 courses of adjuvant chemotherapy with paclitaxel, epirubicin, and carboplatin, and there have been no signs of recurrence for 10 months.
除平滑肌肉瘤、癌肉瘤和子宫内膜间质肉瘤外，子宫间叶肿瘤极为罕见。我们报告一例子宫上皮样血管肉瘤病例，并回顾此前关于此类罕见肿瘤的文献。一名48岁女性，有1年腹部胀满病史，体重减轻10kg。盆腔磁共振成像（MRI）显示巨大（30×18cm）子宫伴变性和坏死。她接受了次全子宫切除术和右侧输卵管卵巢切除术。术后我们将肿块诊断为由平滑肌瘤发生的上皮样血管肉瘤。在平滑肌瘤内观察到2cm×数毫米范围内的血管扩张，在管腔侧表面观察到非典型细胞增殖。肿瘤呈部分精细血管结构，伴有明显核异型性和核分裂象。她接受了6个疗程的紫杉醇、表柔比星和卡铂辅助化疗，10个月来无复发迹象。
