Zhou Fang-Fang, He Ying-Tao, Li Ying, Zhang Min, Chen Fang-Hong
Department of Ultrasound, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China.
Department of Pathology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China.
World J Clin Cases. 2021 Aug 16;9(23):6907-6915. doi: 10.12998/wjcc.v9.i23.6907.
Endometrial stromal tumors originate from the endometrial stroma and account for < 2% of all uterine tumors. Uterine tumor resembling an ovarian sex cord tumor (UTROSCT) is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors. Here, we report a case of UTROSCT in a 51-year-old woman.
A 51-year-old woman had irregular menses for 6 mo. The patient visited a local hospital for vaginal bleeding. Pelvic computed tomography (CT) showed a mass in the pelvic cavity. Five days later, she came to our hospital for further diagnosis. The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor. She then underwent total removal of the uterus with bilateral salpingectomy. Postoperative histological examination showed that the tumor cells had abundant cytoplasm, ovoid and spindle-shaped nuclei, fine chromatin, a high nucleoplasm ratio, and a lamellar distribution. The findings were consistent with UTROSCT, and the results of immunohistochemical analysis supported that diagnosis. The tumor was International Federation of Gynecology and Obstetrics stage IB. No adjuvant therapy was administered after radical surgery. The patient was followed up for 58 mo, and no recurrence was found.
We report a case of UTROSCT with abnormal menstruation as a symptom, which is one of the most common symptoms. In patients with vaginal bleeding, ultrasonography can be used as a screening test because of its convenience, speed, and lack of radiation exposure. For patients with long-term tamoxifen use, routine monitoring of the endometrium is recommended. As UTROSCT may have low malignant potential, surgery remains the primary management strategy. Additionally, fertility preservation in patients of childbearing age is a vital consideration.
子宫内膜间质肿瘤起源于子宫内膜间质，占所有子宫肿瘤的比例小于2%。根据世界卫生组织最新的女性生殖器官肿瘤分类，子宫肿瘤样卵巢性索肿瘤（UTROSCT）是一种罕见的子宫内膜间质及相关肿瘤的组织学类型。在此，我们报告一例51岁女性的UTROSCT病例。
一名51岁女性月经不规律6个月。患者因阴道出血前往当地医院就诊。盆腔计算机断层扫描（CT）显示盆腔有一肿块。五天后，她来我院进一步诊断。我院的增强CT和盆腔超声检查结果提示为盆腔恶性肿瘤。随后她接受了子宫全切术及双侧输卵管切除术。术后组织学检查显示肿瘤细胞胞质丰富，核呈卵圆形和梭形，染色质细腻，核质比高，呈层状分布。这些发现与UTROSCT一致，免疫组化分析结果支持该诊断。肿瘤为国际妇产科联盟分期IB期。根治性手术后未进行辅助治疗。对患者进行了58个月的随访，未发现复发。
我们报告一例以月经异常为症状的UTROSCT病例，月经异常是最常见的症状之一。对于阴道出血患者，超声检查因其方便、快捷且无辐射暴露，可作为筛查手段。对于长期使用他莫昔芬的患者，建议定期监测子宫内膜。由于UTROSCT的恶性潜能可能较低，手术仍然是主要的治疗策略。此外，育龄患者的生育功能保留是一个至关重要的考虑因素。
