Hiratsuka Daiki, Tsukazaki Takehiro, Sone Kenbun, Neriishi Kazuaki, Takechi Kimihiro
Department of Obstetrics and Gynecology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Department of Obstetrics and Gynecology, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira-shi, Tokyo, Japan.
Case Rep Obstet Gynecol. 2022 Jan 31;2022:1630192. doi: 10.1155/2022/1630192. eCollection 2022.
Uterine inversion is a rare puerperal event in the third stage of labor. Nonpuerperal uterine inversion is even rarer and is mainly caused by uterine fibroids, uterine sarcoma, or endometrial cancer. This is the first report of uterine inversion caused by cervical cancer. A 67-year-old woman presented with a 10 cm pelvic mass. Contrast-enhanced magnetic resonance imaging revealed uterine inversion, which was preoperatively diagnosed to be caused by endometrial cancer and was treated using an extended abdominal hysterectomy. Postoperative histopathological examination revealed that the primary tumor was a squamous cell carcinoma with coexistent high-grade squamous intraepithelial lesions and small-cell neuroendocrine carcinoma. Immunostaining was diffusely positive for p16 and negative for estrogen receptors. The postoperative diagnosis was cervical squamous cell carcinoma. Our observations suggested that cervical carcinoma can cause uterine inversion by invading the corpus.
子宫内翻是分娩第三产程中一种罕见的产后事件。非产后子宫内翻更为罕见,主要由子宫肌瘤、子宫肉瘤或子宫内膜癌引起。这是首例由宫颈癌导致子宫内翻的报告。一名67岁女性出现一个10厘米的盆腔肿物。增强磁共振成像显示子宫内翻,术前诊断为由子宫内膜癌引起,并采用扩大经腹子宫切除术进行治疗。术后组织病理学检查显示原发性肿瘤为鳞状细胞癌,并存高级别鳞状上皮内病变和小细胞神经内分泌癌。免疫染色p16弥漫性阳性,雌激素受体阴性。术后诊断为宫颈鳞状细胞癌。我们的观察结果提示,宫颈癌可通过侵犯子宫体导致子宫内翻。