Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McMaster University, Juravinski Cancer Centre, Hamilton, ON.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McMaster University, Juravinski Cancer Centre, Hamilton, ON.
J Obstet Gynaecol Can. 2020 Oct;42(10):1262-1266. doi: 10.1016/j.jogc.2019.12.012. Epub 2020 Mar 12.
Well-differentiated papillary mesothelioma (WDPM) is a rare tumor of unknown malignant potential. It is typically diagnosed incidentally during benign gynaecologic surgery. We report the first published case of WDPM in a woman with synchronous serous carcinomas of the gynaecologic tract and highlight lessons learned for general gynaecologists and gynaecologic oncologists alike.
A 62-year-old woman was referred for assessment and management of a pelvic mass. Intraoperatively, metastatic high-grade carcinoma was identified and the patient underwent a successful debulking procedure that identified 3 synchronous tumors: ovarian high-grade serous carcinoma, endometrial serous carcinoma, and 2 foci of pelvic WDPM.
This case of WDPM with 2 synchronous serous gynaecologic tumors is a novel addition to the reported literature and offers many learning points about the disease. Gynaecologic surgeons should be familiar with WDPM, as it is predominantly found in reproductive-aged women undergoing benign gynaecologic surgery, may be linked with endometriosis, and has an unclear malignant potential. Multidisciplinary care is essential for accurate diagnosis. Further research is needed to clarify the optimal management and surveillance of WDPM.
高分化乳头状间皮瘤（WDPM）是一种罕见的恶性潜能不明的肿瘤。它通常是在良性妇科手术中偶然诊断出来的。我们报告了首例 WDPM 病例，该病例发生在一名患有同步性妇科生殖道浆液性癌的女性中，并强调了普通妇科医生和妇科肿瘤医生都应吸取的经验教训。
一名 62 岁女性因盆腔肿块就诊。术中发现转移性高级别癌，患者成功进行了肿瘤减灭术，术中发现 3 个同步肿瘤：卵巢高级别浆液性癌、子宫内膜浆液性癌和 2 个盆腔 WDPM 病灶。
本病例为 WDPM 伴 2 个同步性妇科生殖道浆液性肿瘤，是文献报道中的一个新发现，为该疾病提供了许多学习点。妇科外科医生应熟悉 WDPM，因为它主要发生在接受良性妇科手术的育龄妇女中，可能与子宫内膜异位症有关，恶性潜能不明。多学科治疗至关重要，以确保准确诊断。需要进一步研究以明确 WDPM 的最佳治疗和监测方案。
