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术前子宫内膜细胞学筛查在两名接受降低风险的输卵管卵巢切除术的患者中意外发现了妇科恶性肿瘤。

Preoperative screening endometrial cytology discovered incidental gynaecological malignancy in two patients undergoing risk-reducing salpingo-oophorectomy.

作者信息

Kojima Riho, Toyoshima Masafumi, Yamamoto Akihito, Suzuki Shunji

机构信息

OB-GY, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.

OB-GY, Nippon Medical School, Bunkyo-ku, Tokyo, Japan

出版信息

BMJ Case Rep. 2023 Mar 14;16(3):e254484. doi: 10.1136/bcr-2022-254484.

Abstract

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.

摘要

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。

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