Martin Alexa K, Jackson Elizabeth G, Edwards Henry D, Stany Michael P
University of Tennessee Health Science Center, Saint Thomas Midtown OBGYN Residency Program, 300 20th Avenue North, Ste 702, Nashville, TN 37203, United States.
Gynecol Oncol Rep. 2020 Mar 18;32:100562. doi: 10.1016/j.gore.2020.100562. eCollection 2020 May.
Dedifferentiated endometrial adenocarcinoma (DEAC) with trophoblastic components is a rare neoplasm with an aggressive behavior and a poor prognosis. Only seven cases have been reported in the literature. We present a 61-year-old patient who was diagnosed with Stage IB dedifferentiated endometrioid adenocarcinoma with trophoblastic elements. A post-operative β-hCG was elevated at 1877 mIU/mL. The patient received 6 cycles of carboplatin and paclitaxel with normalization of β-hCG; however, three months after completion of chemotherapy, her β-hCG increased to 39 mIU/mL and a mass overlaying the psoas muscle was noted on imaging. The mass was resected and confirmed to be recurrent disease. Four cycles of bleomycin, etoposide, and cisplatin were administered, and the patient remains without evidence of disease 3 years after completing treatment. Due to the small number of reported cases of DEAC with trophoblastic components, there is limited information regarding the appropriate first-line adjuvant chemotherapy regimen.
伴有滋养层成分的去分化子宫内膜腺癌（DEAC）是一种罕见的肿瘤，具有侵袭性，预后较差。文献中仅报道了7例。我们报告一名61岁的患者，被诊断为伴有滋养层成分的ⅠB期去分化子宫内膜样腺癌。术后β-hCG升高至1877 mIU/mL。该患者接受了6个周期的卡铂和紫杉醇治疗，β-hCG恢复正常；然而，化疗结束3个月后，她的β-hCG升至39 mIU/mL，影像学检查发现腰大肌上有一个肿块。该肿块被切除，证实为复发性疾病。给予了4个周期的博来霉素、依托泊苷和顺铂治疗，患者在完成治疗3年后仍无疾病证据。由于伴有滋养层成分的DEAC报道病例较少，关于合适的一线辅助化疗方案的信息有限。
