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起源于子宫内膜的原发性卵黄囊瘤:一例病例报告及文献复习

Primary yolk sac tumor originating from the endometrium: A case report and literature review.

作者信息

Song Liang, Wei Xiaoxia, Wang Danqing, Yang Kaixuan, Qie Mingrong, Yin Rutie, Li Qingli

机构信息

The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education.

出版信息

Medicine (Baltimore). 2019 Apr;98(15):e15144. doi: 10.1097/MD.0000000000015144.

Abstract

RATIONALE

Yolk sac tumors (YSTs) are malignant germ cell tumors that secrete alpha-fetoprotein (AFP). These tumors commonly develop in infants, young children, and young women and often originate in the gonads. Primary endometrial YST is a very rare malignancy, and a primary endometrial YST in the absence of abnormal AFP levels is even rarer.

PATIENT CONCERNS

A 38-year-old woman presented with the chief complaint of prolonged menstruation and increased menstrual bleeding with a duration of more than 2 months.

DIAGNOSES

Postoperative pathology confirmed a diagnosis of endometrial YST with metastasis to the greater omentum (stage IVB).

INTERVENTIONS

The patient underwent a laparoscopic extrafascial hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy, abdominal para-aortic lymphadenectomy, omentectomy, and appendectomy. Additionally, she received 6 courses of multidrug chemotherapy (bleomycin, etoposide, and cisplatin; BEP).

OUTCOMES

After completing chemotherapy, the patient underwent regular follow-up examinations. No recurrence was noted during a 24-month follow-up period.

LESSONS

YST is mainly treated using surgery and chemotherapy, which may spare endocrine functions in young patients. The BEP regimen appears to be an effective postoperative chemotherapy regimen for patients with endometrial YST.

摘要

理论依据

卵黄囊瘤(YSTs)是分泌甲胎蛋白(AFP)的恶性生殖细胞肿瘤。这些肿瘤常见于婴儿、幼儿和年轻女性,通常起源于性腺。原发性子宫内膜卵黄囊瘤是一种非常罕见的恶性肿瘤,而在甲胎蛋白水平正常情况下的原发性子宫内膜卵黄囊瘤更为罕见。

患者情况

一名38岁女性,主要症状为月经延长和月经量增多,持续时间超过2个月。

诊断

术后病理确诊为子宫内膜卵黄囊瘤伴大网膜转移(IVB期)。

干预措施

患者接受了腹腔镜筋膜外子宫切除术、双侧附件切除术、盆腔淋巴结清扫术、腹主动脉旁淋巴结清扫术、大网膜切除术和阑尾切除术。此外,她接受了6个疗程的多药化疗(博来霉素、依托泊苷和顺铂;BEP方案)。

结果

完成化疗后,患者接受定期随访检查。在24个月的随访期内未发现复发。

经验教训

卵黄囊瘤主要采用手术和化疗治疗,这可能保留年轻患者的内分泌功能。BEP方案似乎是子宫内膜卵黄囊瘤患者有效的术后化疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2709/6485813/88402c7e32aa/medi-98-e15144-g001.jpg

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