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子宫浆膜层子宫内膜异位灶中呈栅栏状排列的透明细胞癌——一例报告并文献复习

Clear cell carcinoma palisading in a focus of endometriosis on the uterine serosa - A case report and review of the literature.

作者信息

Bahall Vishal, De Barry Lance, Jaggernauth Colin

机构信息

Department of Obstetrics and Gynaecology, San Fernando General Hospital, South-West Regional Health Authority, Trinidad and Tobago.

出版信息

Case Rep Womens Health. 2022 Jul 2;35:e00428. doi: 10.1016/j.crwh.2022.e00428. eCollection 2022 Jul.

Abstract

BACKGROUND

Clear cell carcinoma arising from the malignant transformation of endometriosis is a rare but aggressive cancer often diagnosed in perimenopausal women. Malignant transformation constitutes a rare complication of endometriosis, with only a few cases reported in the medical literature. Clear cell carcinoma and endometrioid carcinoma are the two most common histological subtypes associated with malignant endometriosis.

CASE PRESENTATION

A 61-year-old Afro-Trinidadian woman underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a degenerated uterine leiomyoma. Histopathology demonstrated an isolated finding of clear cell carcinoma occurring within an endometriotic cyst on the uterine serosa. Subsequent surgical staging demonstrated early-stage disease associated with a high-risk histological subtype and the patient was referred for adjuvant chemoradiotherapy.

CONCLUSION

This case highlights the clinical manifestations and treatment modalities employed for an early-stage high-risk subtype of endometriosis-associated cancer. In light of the few publications on this clinical entity, we hope to raise awareness of this unique complication of endometriosis and contribute evidence to the development of standardized treatment protocols.

摘要

背景

由子宫内膜异位症恶变而来的透明细胞癌是一种罕见但侵袭性强的癌症,常于围绝经期女性中被诊断出来。恶变是子宫内膜异位症的一种罕见并发症,医学文献中仅有少数病例报道。透明细胞癌和子宫内膜样癌是与恶性子宫内膜异位症相关的两种最常见的组织学亚型。

病例介绍

一名61岁的非裔特立尼达女性因子宫平滑肌瘤退变接受了全腹子宫切除术及双侧输卵管卵巢切除术。组织病理学显示在子宫浆膜层的一个子宫内膜异位囊肿内发现了孤立的透明细胞癌。随后的手术分期显示为早期疾病,伴有高危组织学亚型,该患者被转诊接受辅助放化疗。

结论

本病例突出了与子宫内膜异位症相关癌症的早期高危亚型的临床表现及所采用的治疗方式。鉴于关于这一临床实体的出版物较少,我们希望提高对子宫内膜异位症这一独特并发症的认识,并为制定标准化治疗方案提供证据。

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