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一名63岁女性腹膜浆液性乳头状癌的疑难诊断:病例报告

Difficult Diagnosis of Peritoneal Serous Papillary Carcinoma in a 63-year-old Woman: A Case Report.

作者信息

Tsuda Banri, Kajiwara Hiroshi, Sakota Naoki, Amatsu Shizuko, Tanaka Akira, Ikeda Masae

机构信息

Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.

出版信息

Tokai J Exp Clin Med. 2019 Sep 20;44(3):49-53.

Abstract

BACKGROUND

Peritoneal serous papillary carcinoma (PSPC) is a rare disease. It is clinically and histologically similar to progressive ovarian serous adenocarcinoma and involves normal-sized ovaries, making it challenging to diagnose. In this report, we describe a case of peritoneal serous papillary carcinoma that was difficult to identify and how we made a correct diagnosis in order to begin a timely course of treatment.

CASE PRESENTATION

A 63-year-old woman with chief complaints of dizziness and abdominal pain was examined, but showed no particular abnormality. Class III cytology of the endometrium was detected through magnetic resonance imaging and a laparotomy was performed on suspicion of endometrial cancer. The patient was finally diagnosed with peritoneal serous papillary carcinoma and was treated with surgical resection and the standard indicated course of chemotherapy.

CONCLUSIONS

The diagnosis and treatment of peritoneal serous papillary carcinoma may be delayed or may not be performed unless Class III findings are detected through uterine mucosal cytology before surgery. Surgeons should not hesitate to perform laparotomy when necessary to identify and appropriately treat patients, even if abnormalities are not detected in the preoperative examination.

摘要

背景

腹膜浆液性乳头状癌(PSPC)是一种罕见疾病。它在临床和组织学上与进展期卵巢浆液性腺癌相似,且累及正常大小的卵巢,这使得诊断具有挑战性。在本报告中,我们描述了一例难以识别的腹膜浆液性乳头状癌病例,以及我们如何做出正确诊断以便及时开始治疗过程。

病例介绍

一名63岁女性,主要症状为头晕和腹痛,经检查未发现特殊异常。通过磁共振成像检测到子宫内膜Ⅲ级细胞学,因怀疑子宫内膜癌而进行了剖腹手术。该患者最终被诊断为腹膜浆液性乳头状癌,并接受了手术切除及标准的化疗疗程。

结论

除非在手术前通过子宫黏膜细胞学检测到Ⅲ级结果,否则腹膜浆液性乳头状癌的诊断和治疗可能会延迟或无法进行。即使术前检查未发现异常,外科医生在必要时也应毫不犹豫地进行剖腹手术,以识别并适当治疗患者。

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