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原发性输卵管恶性苗勒管混合瘤伴宫颈转移:1例罕见病例报告及文献复习

Primary malignant mixed Müllerian tumors of the fallopian tube with cervix metastasis: A rare case report and literature review.

作者信息

Zhang QinHe, Liu Ailian, Wu Jing Jun, Niu Miao, Zhao Ying, Tian Shi Feng, Chen AnLiang, Zhong Lin

机构信息

First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.

出版信息

Medicine (Baltimore). 2018 Jul;97(28):e11311. doi: 10.1097/MD.0000000000011311.

Abstract

RATIONALE

Primary malignant mixed mullerian tumors of the fallopian tube is very rare and has only 1 case in the current literature with cervix metastasis.

PATIENT CONCERNS

We reported a 49-year-old woman sufferring from primary malignant mixed mullerian tumors of the fallopian tube with cervix metastasis, and the imaging examination found a strip of solid mass in the right fallopian tube and a nodular mass in cervical canal, which were both hyperintense on T2 weighted image (T2WI) and diffusion weighted image (DWI) and continuous moderate enhancement on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

DIAGNOSES

The diagnosis was confirmed according to the specific anatomical location and pathological examination which was proved as primary malignant mixed mullerian tumors of the fallopian tube with cervix metastasis.

INTERVENTIONS

The patient underwent radical hysterctomy, bilateral adnexectomy, pelvic lymph node dissection, omentum majus excision and intravenous chemotherapy.

OUTCOMES

Her posttreatment condition was good.

LESSONS

Primary malignant mixed mullerian tumors of the fallopian tube can be located by magnetic resonance image examination, which may also offer several diagnostic tips according to changes in signal and enhancement. When combined with pathological findings, qualitative diagnosis can be determined. Surgery and adjuvant chemotherapy are considered as effective methods. Our paper discussed its epidemiology, clinical symptoms, pathologic characters, therapeutic method as well as magnetic resonance imaging findings suggesting the diagnosis and differential diagnosis, including precontrast scan, contrast scan and diffusion weighted image and provided magnetic resonance imaging characteristics of primary malignant mixed mullerian tumors of the fallopian tube described in other literatures.

摘要

原理

原发性输卵管恶性苗勒管混合瘤非常罕见,目前文献中仅有1例伴有宫颈转移。

患者情况

我们报告了1例49岁患有原发性输卵管恶性苗勒管混合瘤伴宫颈转移的女性,影像学检查发现右侧输卵管有条状实性肿块,宫颈管内有结节状肿块,二者在T2加权像(T2WI)和扩散加权像(DWI)上均呈高信号,在动态对比增强磁共振成像(DCE-MRI)上呈持续中等强化。

诊断

根据特定的解剖位置及病理检查确诊为原发性输卵管恶性苗勒管混合瘤伴宫颈转移。

干预措施

患者接受了根治性子宫切除术、双侧附件切除术、盆腔淋巴结清扫术、大网膜切除术及静脉化疗。

结果

她治疗后的情况良好。

经验教训

原发性输卵管恶性苗勒管混合瘤可通过磁共振成像检查定位,其信号及强化变化也可提供一些诊断线索。结合病理结果可明确定性诊断。手术及辅助化疗被认为是有效的治疗方法。我们的论文讨论了其流行病学、临床症状、病理特征、治疗方法以及提示诊断和鉴别诊断的磁共振成像表现,包括平扫、增强扫描及扩散加权像,并提供了其他文献中描述的原发性输卵管恶性苗勒管混合瘤的磁共振成像特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34fa/6076084/673219787f03/medi-97-e11311-g001.jpg

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