Khalifa Mahmoud A, Atri Mostafa, Klein Molly E, Ghatak Sayak, Murugan Paari
Department of Laboratory Medicine and Pathology, University of Minnesota, MN.
Department of Medical Imaging, University of Toronto, Toronto, ON.
Semin Ultrasound CT MR. 2019 Aug;40(4):358-363. doi: 10.1053/j.sult.2019.04.004. Epub 2019 Apr 18.
The coexistence of endometrial adenocarcinoma and adenomyosis in the same uterus is a common phenomenon. In many of such affected patients foci of adenomyosis could also be colonized by adenocarcinoma. The various permutations arising from these scenarios pose preoperative imaging and postoperative pathologic staging challenges. This article aims to raise awareness of these staging issues and lists some of the relevant practical approaches. Adenomyosis reduces the accuracy of magnetic resonance imaging in assessing the depth of invasion as it reduces the contrast between the endometrial cancer adenomyosis-involved myometrium. The article also offers an alternate argument for staging cancers where myoinvasion is found deep in the myometrium, arising from cancer-positive adenomyotic foci when the surface tumor is either limited to the endometrium or to the inner half of myometrium.
子宫内膜腺癌与子宫腺肌病在同一子宫内并存是一种常见现象。在许多此类受影响的患者中，腺肌病病灶也可能被腺癌侵犯。这些情况产生的各种排列组合给术前影像学检查和术后病理分期带来了挑战。本文旨在提高对这些分期问题的认识，并列出一些相关的实用方法。腺肌病会降低磁共振成像评估浸润深度的准确性，因为它会减少子宫内膜癌累及腺肌病的肌层之间的对比度。本文还针对当表面肿瘤局限于子宫内膜或肌层内半部分时，因癌阳性腺肌病病灶导致肌层深部发现肌层浸润的癌症分期提出了另一种观点。
