Kojima Riho, Toyoshima Masafumi, Yamamoto Akihito, Suzuki Shunji
OB-GY, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
OB-GY, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
BMJ Case Rep. 2023 Mar 14;16(3):e254484. doi: 10.1136/bcr-2022-254484.
Pelvic ultrasonography and measurement of serum cancer antigen 125 (CA-125) are recommended for preoperative evaluation before performing risk-reducing salpingo-oophorectomy (RRSO). We report our experience with two patients in whom an incidental gynaecological malignancy was found using endometrial cytology as a preoperative screening test for RRSO. Patient 1 was an early 50s woman with a pathologic variant of Transvaginal ultrasonography showed no endometrial abnormalities, but preoperative endometrial cytology revealed high-grade serous carcinoma. The patient underwent total hysterectomy, bilateral adnexectomy, pelvic and para-aortic lymph node dissection, and omentectomy. Patient 2 was a late 40s woman with a pathological variant of Transvaginal ultrasonography showed mild enlargement of the left ovary, and her CA-125 level was elevated. Preoperative endometrial cytology revealed high-grade serous cancer. She underwent total hysterectomy, bilateral adnexectomy and omentectomy. These case reports illustrate the importance of preoperative screening-including endometrial cytology-before performing RRSO.
在进行降低风险的输卵管卵巢切除术(RRSO)之前,推荐进行盆腔超声检查和血清癌抗原125(CA-125)检测以进行术前评估。我们报告了两例患者的情况,在这两例患者中,术前使用子宫内膜细胞学检查作为RRSO的筛查试验时意外发现了妇科恶性肿瘤。患者1是一名50岁出头的女性,经阴道超声检查显示子宫内膜无异常,但术前子宫内膜细胞学检查发现高级别浆液性癌。该患者接受了全子宫切除术、双侧附件切除术、盆腔和腹主动脉旁淋巴结清扫术以及大网膜切除术。患者2是一名快50岁的女性,经阴道超声检查显示左卵巢轻度增大,其CA-125水平升高。术前子宫内膜细胞学检查发现高级别浆液性癌。她接受了全子宫切除术、双侧附件切除术和大网膜切除术。这些病例报告说明了在进行RRSO之前进行术前筛查(包括子宫内膜细胞学检查)的重要性。