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原发性阴道尤文肉瘤合并子宫肌瘤:一例报告。

Primary vaginal Ewing sarcoma with uterine fibroid: A case report.

作者信息

Xu Maolin, Liu Yulin, Zeng Shue, Wang Hongbin, Weng Gaolong, Li Fang

机构信息

Department of Radiology.

Department of Ultrasound.

出版信息

Medicine (Baltimore). 2020 Jul 2;99(27):e20859. doi: 10.1097/MD.0000000000020859.

Abstract

RATIONALE

Extra osseous Ewing sarcoma (ES), an uncommon malignant neoplasm, accounts for about 15% of Ewing sarcoma, which mainly affects paravertebral region, lower extremity, chest wall, retroperitoneum, pelvis, and hip. Here is a 54-year-old woman of primary vaginal Ewing sarcoma with uterine fibroid, which has been fewly known or reported.

PATIENT CONCERNS

The patient was admitted to our hospital because of vaginal pain. Her uterus showed as parallel position and enlarged as about 3 months of pregnancy size.

DIAGNOSIS

Magnetic resonance imaging (MRI) and ultrasonography (US) demonstrated 2 heterogeneous masses in the vagina and uterus, respectively. Ultrasound-guided puncture biopsy revealed a malignant tumor in the right lateral vaginal wall.

INTERVENTIONS

The patient was treated by hysterectomy, bilateral salpingo-oophorectomy, and tumors excision, with the subsequent treatment of chemotherapy.

OUTCOMES

The patient recovered well without local recurrence for >1 year.

LESSONS

Primary vaginal Ewing sarcoma is extremely rare. The treatments of uterine fibroid include uterine artery embolization and surgical options, While wide local excision followed by adjuvant chemotherapy and/or radiotherapy should be recommended for the vaginal ES.

摘要

理论依据

骨外尤文肉瘤(ES)是一种罕见的恶性肿瘤,约占尤文肉瘤的15%,主要累及椎旁区域、下肢、胸壁、腹膜后、骨盆和髋部。本文报道一名54岁患有原发性阴道尤文肉瘤合并子宫肌瘤的女性,该病鲜为人知或报道较少。

患者情况

患者因阴道疼痛入院。其子宫呈前倾位,增大如妊娠3个月大小。

诊断

磁共振成像(MRI)和超声检查(US)分别在阴道和子宫内显示出2个不均匀肿块。超声引导下穿刺活检显示右侧阴道壁有恶性肿瘤。

干预措施

患者接受了子宫切除术、双侧输卵管卵巢切除术和肿瘤切除术,随后进行化疗。

结果

患者恢复良好,1年多无局部复发。

经验教训

原发性阴道尤文肉瘤极为罕见。子宫肌瘤的治疗方法包括子宫动脉栓塞术和手术选择,而对于阴道尤文肉瘤,应推荐广泛局部切除,随后进行辅助化疗和/或放疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be3/7337545/0bb4f78e87f0/medi-99-e20859-g001.jpg

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