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腹壁巨大转移性子宫内膜样腺癌的整形手术:一例报告并文献复习

Plastic surgery for giant metastatic endometrioid adenocarcinoma in the abdominal wall: A case report and review of literature.

作者信息

Wang Jing-Yuan, Wang Zhi-Qi, Liang Si-Chen, Li Guang-Xue, Shi Jing-Li, Wang Jian-Liu

机构信息

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.

Department of Plastic Surgery, Peking University People's Hospital, Beijing 100044, China.

出版信息

World J Clin Cases. 2022 Jul 6;10(19):6702-6709. doi: 10.12998/wjcc.v10.i19.6702.

Abstract

BACKGROUND

Endometrial cancer (EC) is a common gynecological malignancy, but metastasis to the abdominal wall is extremely rare. Therefore, an appropriate treatment approach for large metastatic lesions with infection remains a great challenge.

CASE SUMMARY

We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma, as defined by International Obstetrics and Gynecology stage II, in which the lesion was complicated by infection. A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago. When admitted to our department, a complete resection of the giant abdominal wall lesion was performed, and a Bard composite mesh was used to reconstruct the abdominal wall. A local flap was used to close the resultant large defect in the external covering of the abdomen. The patient underwent chemotherapy following cytoreductive surgery. Pathology revealed metastasis of EC, and molecular subtyping showed copy number high of TP53 mutation, implying a poor prognosis.

CONCLUSION

When EC patients develop giant abdominal wall metastasis, a plastic surgeon should be included before contemplating resection of tumors.

摘要

背景

子宫内膜癌(EC)是一种常见的妇科恶性肿瘤,但转移至腹壁极为罕见。因此,对于伴有感染的大型转移病灶,选择合适的治疗方法仍是一项巨大挑战。

病例摘要

我们报告一例65岁女性,其患有国际妇产科联盟II期子宫内膜样腺癌腹壁转移,且病灶合并感染。3年前因结肠转移接受了右半结肠切除术,初始疾病为妇科癌症。入院时,对巨大腹壁病灶进行了完整切除,并使用巴德复合补片重建腹壁。采用局部皮瓣封闭腹部外覆盖层由此产生的大缺损。患者在肿瘤细胞减灭术后接受了化疗。病理检查显示为EC转移,分子亚型显示TP53突变拷贝数高,提示预后不良。

结论

当EC患者发生巨大腹壁转移时,在考虑切除肿瘤之前应邀请整形外科医生参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a10/9294911/2c97fb2a98b1/WJCC-10-6702-g001.jpg

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