Matsukawa Hitomi, Ota Nami, Nishioka Kaho, Noguchi Tomoko, Iwahashi Naoyuki, Mabuchi Yasushi, Yagi Shigetaka, Minami Sawako, Ino Kazuhiko
Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
Mol Clin Oncol. 2021 Nov;15(5):236. doi: 10.3892/mco.2021.2400. Epub 2021 Sep 20.
Low-grade endometrial stromal sarcoma (LG-ESS) is a rare tumor that mostly occurs in perimenopausal women. Treatment with total hysterectomy and bilateral salpingo-oophorectomy is recommended, although fertility preservation or ovarian preservation may be considered in younger patients. The present study reports a case of LG-ESS in a young woman diagnosed after resection of endometrial polyp-like lesions. A 26-year-old nulligravid woman was referred to our hospital after being diagnosed with endometrial polyps. Hysteroscopic endometrial polypectomy was performed twice, and LG-ESS was suspected on postoperative pathological examination. Magnetic resonance imaging revealed a tumor 5-cm in diameter on the right side of the uterus. In light of the young age of the patient, tumorectomy was first performed, and postoperative pathological diagnosis was LG-ESS with the positive resection margin. After thorough discussion with the patient about fertility preservation and recurrence risk, a total abdominal hysterectomy and ovarian preservation was performed. Medroxyprogesterone therapy was performed postoperatively and no recurrence was observed for 2 years.
低级别子宫内膜间质肉瘤（LG-ESS）是一种罕见肿瘤，主要发生于围绝经期女性。尽管对于年轻患者可考虑保留生育功能或保留卵巢，但推荐行全子宫切除术及双侧输卵管卵巢切除术。本研究报告了1例年轻女性LG-ESS病例，该病例在切除子宫内膜息肉样病变后得以确诊。一名26岁未孕女性在被诊断为子宫内膜息肉后转诊至我院。行宫腔镜下子宫内膜息肉切除术2次，术后病理检查怀疑为LG-ESS。磁共振成像显示子宫右侧有一个直径5厘米的肿瘤。鉴于患者年轻，首先进行了肿瘤切除术，术后病理诊断为LG-ESS且切缘阳性。在与患者就保留生育功能和复发风险进行充分讨论后，进行了全腹子宫切除术并保留了卵巢。术后给予甲羟孕酮治疗，2年未观察到复发。
