Moreira-Barros Joana, Huang Kuan-Gen, Tsai Tsung-Hsun
Department of Obstetrics and Gynecology, Hospital Pedro Hispano, Matosinhos, Portugal.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Rev Bras Ginecol Obstet. 2018 Dec;40(12):800-802. doi: 10.1055/s-0038-1673678. Epub 2018 Oct 11.
To describe a case of radiation-induced uterine carcinosarcoma 6 years after a cervical squamous cell carcinoma treatment, which imposed some diagnostic and management challenges.
A 57-year-old woman with a history of pelvic chemoradiotherapy ∼ 6.5 years before the event described in this study, following an International Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical cancer, presented with a cervical mass, involving the uterine cavity, the cervical canal and the upper two thirds of the vagina. The biopsy showed a poorly differentiated carcinoma, and a positron emission tomography (PET) scan excluded distant metastasis, although it was unable to define the origin of the tumor as either a new primary malignancy of the endometrium/cervix or as a cervical recurrence. Surgical staging procedure was performed, and the diagnosis was endometrial carcinosarcoma, FIGO stage IIB. The patient was not able to complete the adjuvant therapy, and the progression of the disease was remarkable.
The present case highlights one of the less common but more serious consequences of radiotherapy for cervical cancer, which has an increasing incidence in younger women, raising concerns about the long-term consequences of its management.
描述1例宫颈癌治疗6年后发生放射性子宫癌肉瘤的病例，该病例带来了一些诊断和处理方面的挑战。
一名57岁女性，在本研究所述事件发生前约6.5年有盆腔放化疗史，此前为国际妇产科联盟（FIGO）IIB期宫颈癌，现出现宫颈肿物，累及子宫腔、宫颈管及阴道上三分之二。活检显示为低分化癌，正电子发射断层扫描（PET）排除远处转移，尽管无法确定肿瘤起源是子宫内膜/宫颈的新原发性恶性肿瘤还是宫颈复发。进行了手术分期，诊断为子宫内膜癌肉瘤，FIGO IIB期。患者无法完成辅助治疗，疾病进展显著。
本病例凸显了宫颈癌放疗较少见但更严重的后果之一，在年轻女性中的发病率不断上升，引发了对其治疗长期后果的担忧。
