Clinical Department of Gynaecologic Oncology, University Hospital for Tumours, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Clinic for Gynaecology, Bethesda Hospital, Basel, Switzerland.
Acta Chir Belg. 2023 Dec;123(6):679-681. doi: 10.1080/00015458.2022.2101332. Epub 2022 Jul 20.
Ichthyosis uteri is an extremely rare condition in which the entire or extensive parts of endometrial lining are replaced by stratified squamous epithelium. Malignant potential of this entity is unclear and its association with dysplastic changes and primary squamous cell carcinoma of the endometrium and endometrial adenocarcinoma has been reported. However, lack of data makes difficult to interpret the significance of neoplasms arising from this condition.
We report a case of ichthyosis uteri associated with squamous cell carcinoma of the endometrium in a 62-year-old female who presented with postmenopausal bleeding and thin endometrium on ultrasound.
Endometrial curettage was performed and revealed high grade squamous intraepithelial lesion. The patient underwent total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and bilateral pelvic lymph node dissection. Microscopic examination of sections revealed squamous cell cancer along with extensive replacement of the endometrial lining by stratified squamous epithelium, consistent with ichthyosis uteri.
If ichthyosis uteri is suspected we recommend hysterectomy in order to rule out possibility of coexisting carcinoma. Also, thin endometrium in women with postmenopausal bleeding does not reliably exclude endometrial cancer.
子宫角化过度症是一种极其罕见的疾病，其子宫内膜的全部或大部分被复层鳞状上皮取代。该疾病的恶性潜能尚不清楚，其与子宫内膜不典型增生、原发性子宫内膜鳞状细胞癌和子宫内膜腺癌有关。然而，由于数据缺乏，难以解释该疾病相关肿瘤的意义。
我们报告了一例 62 岁女性的子宫角化过度症合并子宫内膜鳞状细胞癌病例，该患者因绝经后出血和超声检查显示子宫内膜薄而就诊。
进行了子宫内膜刮宫术，结果显示高级别鳞状上皮内病变。患者接受了全腹腔镜子宫切除术、双侧输卵管卵巢切除术和双侧盆腔淋巴结清扫术。切片的显微镜检查显示伴有广泛子宫内膜被复层鳞状上皮取代的鳞状细胞癌，符合子宫角化过度症的表现。
如果怀疑存在子宫角化过度症，我们建议行子宫切除术以排除同时存在的癌的可能性。此外，绝经后出血的女性子宫内膜薄并不能可靠地排除子宫内膜癌。
