Zhang Qing-Yun, Li Ting-Chao, Lin Jiang, He Lian-Li, Liu Xiao-Yun
Department of Gynecology and Obstetrics, The First People's Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.
Pathology Department, The First People's Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.
World J Clin Cases. 2021 Aug 26;9(24):7110-7116. doi: 10.12998/wjcc.v9.i24.7110.
Extramedullary plasmacytoma (EMP), a variant form of myeloma, is a rare solid plasma cell tumor that originates from the bone marrow hematopoietic tissue and accounts for about 3% of all plasma cell tumors. EMP can affect various tissues and organs, about 90% of which is found in the head and neck. However, EMP in the reproductive organs is rare, and is difficult to be distinguished from other primary or metastatic genital tumors according to clinical symptoms and imaging findings.
Herein, we report a case with coexistence of EMP and squamous cell carcinoma in the cervix. The first histopathological report of neoplasms on the surface of the cervix and vagina showed an EMP. Both ultrasound and pelvic enhanced magnetic resonance imaging (MRI) indicated that there was a tumor in the cervix. Thus, another cervical biopsy and pathological examination were performed, which indicated EMP combined with squamous cell carcinoma. Then, the patient underwent extensive total hysterectomy (type C1) + systemic lymph node dissection and received 25 external pelvic irradiations with a dose of 50 Gy following surgery. During 2-year follow-up, no recurrence was reported.
In conclusion, EMP involving the reproductive system is relatively rare. In this case, MRI, B-ultrasound, and cervical canal scraping were used to further determine the diagnosis of EMP combined with squamous cell carcinoma. The patient had improved prognosis after appropriate treatments.
髓外浆细胞瘤(EMP)是骨髓瘤的一种变异形式,是一种罕见的实体性浆细胞瘤,起源于骨髓造血组织,约占所有浆细胞瘤的3%。EMP可累及多种组织和器官,其中约90%发生于头颈部。然而,生殖器官的EMP较为罕见,根据临床症状和影像学表现难以与其他原发性或转移性生殖器肿瘤相鉴别。
在此,我们报告一例宫颈同时存在EMP和鳞状细胞癌的病例。宫颈和阴道表面肿瘤的首次组织病理学报告显示为EMP。超声和盆腔增强磁共振成像(MRI)均提示宫颈有肿瘤。因此,再次进行宫颈活检及病理检查,结果显示为EMP合并鳞状细胞癌。随后,患者接受了广泛全子宫切除术(C1型)+系统性淋巴结清扫,并在术后接受了25次盆腔外照射,剂量为50 Gy。在2年的随访期间,未报告复发情况。
总之,累及生殖系统的EMP相对罕见。在本病例中,通过MRI、B超及宫颈管刮片进一步明确了EMP合并鳞状细胞癌的诊断。经过适当治疗,患者预后改善。