Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Educationa.
Medicine (Baltimore). 2021 Apr 2;100(13):e25377. doi: 10.1097/MD.0000000000025377.
Female adnexal tumors of probable Wolffian origin (FATWOs) are rare gynecologic neoplasms arising from the mesonephric duct remnants. Less than 90 cases have been reported in the English literature. Although most cases of FATWO are considered benign, recurrence and metastasis may occur in very few cases during the course of the disease. Due to the small number of recurrent and metastatic FATWO cases, there are no clear recommendations regarding optimal treatment.
A 75-year-old postmenopausal woman, who underwent a mass excision of the right broad ligament three years ago, was found to have a right adnexal mass during a regular postoperative physical examination.
Vaginal ultrasound examination revealed a cystic and solid mass approximately 3.6 × 4.4 × 3.8 cm on the right side of the uterus. Three years ago, the mass of the right broad ligament was diagnosed with FATWO in the local hospital. Following extensive immunohistochemistry analysis and after reviewing the histology slides from the primary tumor, the final diagnosis of the mass on the right side of the uterus was recurrent and metastatic FATWO.
The patient underwent laparoscopic mass excision, hysterectomy and resection of the metastatic lesion in the small intestine, and then she received 6 cycles of docetaxel and carboplatin-based chemotherapy.
The disease has recurred three years after the first surgery in the local hospital. After the second surgery followed by systemic chemotherapy, there is no evidence of recurrence with 24 months of follow-up till now.
FATWO is considered a benign entity. However, a few FATWOs have been shown to behave aggressively. Due to only a few reported cases, there are no comprehensive recommendations regarding the optimal clinical management of recurrent and metastatic FATWOs. Complete surgical resection followed by combination chemotherapy is considered to be the most effective therapy for recurrent and metastatic FATWOs. Chemotherapy with docetaxel plus carboplatin, which is most commonly used in malignant cases, may be effective in the treatment of recurrent and metastatic FATWOs.
女性附件沃氏来源的肿瘤（FATWO）是一种罕见的来源于中肾管残余的妇科肿瘤。在英文文献中，不到 90 例病例被报道。尽管大多数 FATWO 病例被认为是良性的，但在疾病过程中，极少数情况下可能会出现复发和转移。由于复发性和转移性 FATWO 病例数量较少，因此对于最佳治疗方法尚无明确建议。
一名 75 岁绝经后妇女，三年前因右侧阔韧带肿块接受肿块切除术，在定期术后体检时发现右侧附件区有肿块。
阴道超声检查显示右侧子宫旁约 3.6×4.4×3.8cm 的囊实性肿块。三年前，在当地医院诊断为右侧阔韧带肿块为 FATWO。经过广泛的免疫组织化学分析，并回顾原发性肿瘤的组织学切片后，右侧子宫肿块的最终诊断为复发性和转移性 FATWO。
患者接受了腹腔镜肿块切除术、子宫切除术和小肠转移病灶切除术，然后接受了 6 个周期的多西紫杉醇和卡铂为基础的化疗。
第一次手术后三年，疾病在当地医院复发。第二次手术后行全身化疗，目前随访 24 个月无复发证据。
FATWO 被认为是一种良性实体。然而，一些 FATWO 表现出侵袭性。由于报道的病例较少，对于复发性和转移性 FATWO 的最佳临床管理尚无全面建议。完全手术切除后联合化疗被认为是复发性和转移性 FATWO 最有效的治疗方法。在恶性病例中最常使用的多西紫杉醇联合卡铂化疗可能对复发性和转移性 FATWO 有效。
