Department of Pathology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Pathology, Jinshan Hospital, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 401122, China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30240. doi: 10.1097/MD.0000000000030240.
The extrauterine adenomyoma is rare and it is extremely rare outside the pelvic cavity. Herein, we reported the first case of a single extrauterine adenomyoma occurring in the lesser omentum.
This case involved a 55-year-old woman who had undergone subtotal gastrectomy and omentectomy for gastric carcinoma. During postoperational pathological examination, 1 lymph node-like mass was coincidentally found in the lesser omentum. The patient had a history of hysterectomy for uterine leiomyoma 8 years ago.
The resected 17 "lymph nodes" from the lesser omentum were routinely checked for possible metastasis of gastric carcinoma. One of lymph node-like mass was microscopically showed that it was composed of benign smooth muscle components, endometrial glands and stroma by HE staining. Therefore, adenomyoma was initially considered.
The lymph node-like mass was removed together with the lesser omentum during the subtotal gastrectomy and omentectomy for gastric carcinoma. No special intervention was performed for the adenomyoma.
Immunohistochemical staining confirmed that smooth muscle tissue was diffusely and strongly positive for Desmin, smooth muscle actin, estrogen receptor, and progesterone receptor, and negative for CD117, Dog-1, S100, and CD34. Endometrial glands and stroma were positive for estrogen receptor and progesterone receptor, and the endometrium interstitium was also positive for CD10. The final diagnosis of extrauterine adenomyoma occurring in the lesser omentum was established.
So far, to the best of our knowledge, total 53 cases of extrauterine adenomyoma have been reported in 45 English reports. The most common location for a single mass was pelvic cavity (37 cases), but rarely outside the pelvic cavity. This is the first case of a single extrauterine adenomyoma occurring in the lesser omentum.
子宫外腺肌瘤罕见，而盆腔外的子宫外腺肌瘤则极其罕见。本文报道首例发生于小网膜的单发子宫外腺肌瘤。
该病例为 55 岁女性，因胃癌行胃大部切除术和大网膜切除术，术后病理检查时偶然发现小网膜有 1 个类似淋巴结的肿块。该患者 8 年前因子宫肌瘤行子宫切除术。
小网膜的 17 个“淋巴结”常规检查胃癌是否有淋巴结转移。其中 1 个类似淋巴结的肿块镜下由良性平滑肌成分、子宫内膜腺体和基质组成，故最初考虑腺肌瘤。
在胃癌行胃大部切除术和大网膜切除术时，一并切除该类似淋巴结的肿块和小网膜。对腺肌瘤未行特殊干预。
免疫组化染色显示，平滑肌组织弥漫且强烈表达结蛋白、平滑肌肌动蛋白、雌激素受体和孕激素受体，而 CD117、Dog-1、S100 和 CD34 阴性。子宫内膜腺体和基质表达雌激素受体和孕激素受体，子宫内膜间质也表达 CD10。最终诊断为小网膜子宫外腺肌瘤。
据我们所知，目前已有 45 篇英文文献报道了 53 例子宫外腺肌瘤，单发肿块最常见的部位是盆腔（37 例），但很少发生在盆腔外。这是首例发生于小网膜的单发子宫外腺肌瘤。
