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一名围绝经期女性的子宫内膜原发性鳞状细胞癌:病例报告。

Primary squamous cell carcinoma of the endometrium in a woman of perimenopausal age: A case report.

作者信息

Zhang Chao, Zhang Hongyan, Yang Linqing, Wang Yunfei, Li Xiaoyu, Guo Jinfeng, Xu Jing

机构信息

School of Clinical Medicine Jining Medical University.

Department of Gynecology.

出版信息

Medicine (Baltimore). 2018 Nov;97(48):e13418. doi: 10.1097/MD.0000000000013418.

Abstract

RATIONALE

Primary squamous cell carcinoma of the endometrium (PSCCE) is a rare entity, and only sporadic cases have been reported in the literature since the 1st report in 1892. This report describes a case of a perimenopausal woman with PSCCE.

PATIENT CONCERNS

A 47-year-old, human papilloma virus type 16-positive, perimenopausal woman was admitted to our hospital with irregular vaginal bleeding for 6 months and secondary anemia.

DIAGNOSES

The patient was diagnosed with stage IIIc primary and moderately differentiated endometrial squamous cell carcinoma.

INTERVENTIONS

The patient underwent diagnostic curettage twice and cold knife conization (CKC). Following this total abdominal hysterectomy combined with bilateral adnexectomy and pelvic lymph node, dissection was performed. After the surgery, the patient was treated with radiotherapy and chemotherapy. Tumor markers were followed up regularly after the operation to monitor tumor recurrence and therapeutic effect.

OUTCOMES

Ninety-two days after the operation, there was tumor recurrence of the left pelvic cavity and the patient died after 11 months of follow-up.

LESSONS

Intrauterine pathology after the 1st diagnostic curettage suggests that high-grade squamous intraepithelial lesion should make the clinician vigilant and investigate the origin of the lesion. Magnetic resonance imaging scans and tumor markers can be used to confirm the diagnosis as soon as possible and avoid unnecessary interventions like CKC.

摘要

原理

子宫内膜原发性鳞状细胞癌(PSCCE)是一种罕见的疾病,自1892年首次报道以来,文献中仅报道过散发病例。本报告描述了一例围绝经期患有PSCCE的女性病例。

患者情况

一名47岁、人乳头瘤病毒16型阳性的围绝经期女性因6个月的不规则阴道出血和继发性贫血入院。

诊断

患者被诊断为IIIc期原发性、中分化子宫内膜鳞状细胞癌。

干预措施

患者接受了两次诊断性刮宫和冷刀锥切术(CKC)。随后进行了全腹子宫切除术、双侧附件切除术和盆腔淋巴结清扫术。术后,患者接受了放疗和化疗。术后定期随访肿瘤标志物以监测肿瘤复发和治疗效果。

结果

术后92天,左盆腔出现肿瘤复发,患者在随访11个月后死亡。

经验教训

首次诊断性刮宫后的宫内病理提示高级别鳞状上皮内病变应引起临床医生警惕并调查病变来源。磁共振成像扫描和肿瘤标志物可用于尽快确诊并避免像CKC这样的不必要干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/802f/6283105/a4ae78c1c6d2/medi-97-e13418-g004.jpg

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