National Hospital Organization Kyoto Medical Center, Department of Obstetrics and Gynecology, Kyoto 612-8555, Japan.
Section of Cancer Medicine, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan.
Curr Oncol. 2022 Mar 28;29(4):2350-2363. doi: 10.3390/curroncol29040190.
BACKGROUND/AIM: Patients with uterine sarcoma comprise 2-5% of all patients with uterine malignancies; however, the morbidity of uterine sarcoma is low compared with that of other gynecological cancers. For many cases, malignant uterine tumors are diagnosed during follow-up of benign uterine leiomyoma. Of the uterine sarcomas, rhabdomyosarcoma is considered a mixed tumor containing components of epithelial cells and mesenchymal cells. Therefore, the onset of primary uterine rhabdomyosarcoma during follow-up of uterine leiomyoma is extremely rare. Rhabdomyosarcoma is a relatively common malignant tumor in children, but rhabdomyosarcoma in adults is extremely rare, accounting for approximately 3% of all patients with soft tissue sarcoma. Rhabdomyosarcoma in children is highly sensitive to chemotherapy and radiation therapy; however, the response to chemotherapy and radiation therapy in adult rhabdomyosarcoma is low and survival in adult rhabdomyosarcoma with metastatic lesions to other organs is approximately 14 months. We experienced a case of pleomorphic rhabdomyosarcoma during the follow-up of a uterine leiomyoma.
We examined the oncological properties of uterine rhabdomyosarcoma in adults using molecular pathological techniques on tissue excised from patients with uterine leiomyoma.
A differential diagnosis was made for this case by molecular pathology, which included candidate biomarkers for uterine smooth muscle tumors. The oncological nature of uterine rhabdomyosarcoma was found to be similar to the oncological properties of uterine leiomyosarcoma. However, in uterine rhabdomyosarcoma, LMP2/β1i-positive cells were clearly observed.
It is expected that establishing a diagnostic and treatment method targeting characteristics of mesenchymal tumor cells will lead to the treatment of malignant tumors with a low risk of recurrence and metastasis.
背景/目的:子宫肉瘤患者占所有子宫恶性肿瘤患者的 2-5%;然而,与其他妇科癌症相比,子宫肉瘤的发病率较低。对于许多病例,恶性子宫肿瘤是在良性子宫肌瘤的随访中诊断出来的。在子宫肉瘤中,横纹肌肉瘤被认为是一种混合肿瘤,包含上皮细胞和间叶细胞的成分。因此,在子宫肌瘤的随访中发生原发性子宫横纹肌肉瘤极为罕见。横纹肌肉瘤是儿童中相对常见的恶性肿瘤,但成人横纹肌肉瘤极为罕见,占所有软组织肉瘤患者的约 3%。儿童横纹肌肉瘤对化疗和放疗高度敏感;然而,成人横纹肌肉瘤对化疗和放疗的反应较低,转移性病变转移到其他器官的成人横纹肌肉瘤的存活率约为 14 个月。我们在子宫肌瘤的随访中遇到了一例多形性横纹肌肉瘤。
我们使用分子病理技术检查了来自子宫肌瘤患者的组织中的成人子宫横纹肌肉瘤的肿瘤特性。
分子病理学对该病例进行了鉴别诊断,包括子宫平滑肌肿瘤的候选生物标志物。子宫横纹肌肉瘤的肿瘤性质与子宫平滑肌肉瘤的肿瘤性质相似。然而,在子宫横纹肌肉瘤中,清楚地观察到 LMP2/β1i 阳性细胞。
预计建立针对间叶肿瘤细胞特征的诊断和治疗方法将导致治疗复发和转移风险低的恶性肿瘤。