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子宫肿瘤酷似卵巢性索肿瘤:6例系列病例呈现多样的组织病理学模式和临床特征。

Uterine tumor resembling ovarian sex cord tumor: A series of six cases displaying varied histopathological patterns and clinical profiles.

作者信息

Kaur Kavneet, Rajeshwari Madhu, Gurung Niteeka, Kumar Hemanth, Sharma Mehar C, Yadav Rajni, Kumar Sunesh, Manchanda Smita, Singhal Seema, Mathur Sandeep R

机构信息

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Pathol Microbiol. 2020 Feb;63(Supplement):S81-S86. doi: 10.4103/IJPM.IJPM_340_19.

Abstract

INTRODUCTION

Uterine tumors resembling ovarian sex cord tumor (UTROSCT) are a unique group of neoplasms with diverse morphology and immunophenotypic characteristics, coexpressing sex cord, epithelial, and smooth-muscle markers. To date, less than 100 cases have been reported and there is paucity of data concerning their clinical behavior.

MATERIALS AND METHODS

All cases of uterine body tumors diagnosed over a period of two and a half years (2016-2018) were retrieved. Histopathological features were reviewed and extended panel of immunohistochemistry was performed to identify cases of UTROSCTs.

RESULTS

Six cases of UTROSCTs were identified with a median age of 46.5 years. Four of them presented with menorrhagia, while two with postmenopausal bleeding including one with a history of carcinoma breast. Three of these cases were initially misdiagnosed as endometrial stromal sarcoma and adenocarcinomas. They all underwent hysterectomy with bilateral salpingo-oophorectomy.

CONCLUSION

It is considered a tumor with low malignant potential; however, one out of six cases (16.7%) in our study showed metastasis, within 1 year of diagnosis. It is important to recognize this entity as it mimics a wide range of both benign and malignant tumors. Molecular pathogenesis and exact management protocols remain elusive due to rarity,hence, multi-institutional studies are warranted.

摘要

引言

子宫肿瘤样卵巢性索肿瘤(UTROSCT)是一组独特的肿瘤,具有多样的形态学和免疫表型特征,同时表达性索、上皮和平滑肌标志物。迄今为止,报道的病例不足100例,关于其临床行为的数据也很匮乏。

材料与方法

检索了在两年半时间(2016 - 2018年)内诊断的所有子宫体肿瘤病例。回顾了组织病理学特征,并进行了扩展的免疫组化检查以识别UTROSCT病例。

结果

共识别出6例UTROSCT,中位年龄为46.5岁。其中4例表现为月经过多,2例表现为绝经后出血,其中1例有乳腺癌病史。这些病例中有3例最初被误诊为子宫内膜间质肉瘤和腺癌。她们均接受了子宫切除术及双侧输卵管卵巢切除术。

结论

它被认为是一种恶性潜能较低的肿瘤;然而,在我们的研究中,6例中有1例(16.7%)在诊断后1年内出现转移。认识到这一实体很重要,因为它可模仿多种良性和恶性肿瘤。由于其罕见性,分子发病机制和确切的治疗方案仍不明确,因此,有必要开展多机构研究。

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