林奇综合征背景下无原发性肿瘤的子宫内膜样癌淋巴结转移的发现。
Discovery of an endometrioid cancer lymph node metastasis without primary tumor in a context of Lynch syndrome.
机构信息
Department of Gynaecological and Breast Oncological Surgery, European Georges-Pompidou Hospital, APHP. Centre, France; Paris University, Faculty of Medicine, Paris, France; INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints-Pères, Paris, France.
Department of Gynaecological and Breast Oncological Surgery, European Georges-Pompidou Hospital, APHP. Centre, France; INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints-Pères, Paris, France.
出版信息
J Gynecol Obstet Hum Reprod. 2021 Mar;50(3):102060. doi: 10.1016/j.jogoh.2021.102060. Epub 2021 Jan 6.
INTRODUCTION
Lynch syndrome is a hereditary predisposition to cancers, including colo-rectal and endometrial cancers in women. Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy is recommended once the parental project is completed in case of identified mutation.
CASE PRESENTATION
We describe the case of a 50-year-old patient with Lynch syndrome and identified MSH6 mutation who underwent a prophylactic hysterectomy with bilateral salpingo-oophorectomy. A left large broad ligament lesion suggestive of a fibroma was intraoperatively discovered and removed. Pathological examination and immunohistochemical study showed a lymph node macro-metastasis of an endometrioid adenocarcinoma, without primary tumor.
DISCUSSION/CONCLUSION: Lymph node metastasis can occur before endometrial cancer but the link with Lynch syndrome remains to be proved. Lymph node assessment by imaging before prophylactic surgery in Lynch syndrome could be considered.
简介
林奇综合征是一种遗传性癌症易感性，包括女性的结肠直肠癌和子宫内膜癌。一旦确定存在突变，建议在完成父母项目后进行预防性手术，包括子宫切除术和双侧输卵管卵巢切除术。
病例介绍
我们描述了一例 50 岁的林奇综合征患者，其 MSH6 基因突变，行预防性子宫切除术和双侧输卵管卵巢切除术。术中发现并切除了左侧大阔韧带病变，提示为纤维瘤。病理检查和免疫组织化学研究显示，存在淋巴结大转移的子宫内膜样腺癌，但无原发性肿瘤。
讨论/结论：淋巴结转移可发生在子宫内膜癌之前，但与林奇综合征的联系仍有待证实。林奇综合征患者在预防性手术前可考虑进行淋巴结影像学评估。
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