Tsuruga Tetsushi, Hirata Tetsuya, Akiyama Ikumi, Matsumoto Yoko, Oda Katsutoshi, Fujii Tomoyuki, Osuga Yutaka
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Department of Obstetrics and Gynecology, Doai Kinen Hospital, Tokyo, Japan.
J Obstet Gynaecol Res. 2019 Aug;45(8):1613-1618. doi: 10.1111/jog.14014. Epub 2019 Jun 10.
Laparoscopic port site endometriosis is less common in abdominal wall endometriosis, and malignant transformation of abdominal wall endometriosis is rare. We reported a case of mixed endometrioid and clear cell carcinoma arising from port site endometriosis. The patient was a 49-year-old woman with a history of laparoscopic excision of ovarian endometrioma. Physical examination revealed a subcutaneous solid tumor around the laparoscopic surgical scar. Imaging showed a suspicious malignancy. She underwent radical marginal resection of the abdominal wall tumor, flap reconstruction of the abdominal wall, hysterectomy, bilateral salpingo-oophorectomy and omental biopsy. Histological examination revealed mixed endometrioid and clear cell carcinoma. Computed tomography scan showed no evidence of recurrence after six cycles of chemotherapy. This is the first case of malignant transformation from laparoscopic trocar site endometriosis.
腹腔镜穿刺孔部位子宫内膜异位症在腹壁子宫内膜异位症中较少见,且腹壁子宫内膜异位症恶变罕见。我们报告了1例由穿刺孔部位子宫内膜异位症引起的子宫内膜样癌和透明细胞癌混合型病例。该患者为49岁女性,有腹腔镜下卵巢子宫内膜瘤切除术史。体格检查发现腹腔镜手术瘢痕周围有皮下实性肿瘤。影像学检查显示有可疑恶性病变。她接受了腹壁肿瘤根治性边缘切除术、腹壁皮瓣重建术、子宫切除术、双侧输卵管卵巢切除术及大网膜活检。组织学检查显示为子宫内膜样癌和透明细胞癌混合型。计算机断层扫描显示化疗6个周期后无复发迹象。这是首例腹腔镜穿刺孔部位子宫内膜异位症恶变病例。