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罕见的宫颈子宫内膜异位症病例及文献综述。

A Rare Case of the Cervical Endometriosis and Overview of the Literature.

机构信息

Department of Reproductive Endocrinology and IVF, Etlik Zubeyde Lady Women Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

出版信息

Reprod Sci. 2023 Sep;30(9):2882-2886. doi: 10.1007/s43032-023-01238-4. Epub 2023 Apr 20.

Abstract

Cervical endometriosis is an uncommon form of endometriosis that is frequently diagnosed incidentally during histopathological evaluation of a hysterectomy or cervical biopsy specimens. Although some cases may be asymptomatic, the symptoms in some patients range from life-threatening hemorrhage to severe chronic pelvic pain. In asymptomatic patients, no further intervention might be required apart from observation and follow-up; however, patients with significant symptoms will require surgery. Primary cervical endometriosis is defined as presence of endometrial tissue on the anterior lip of the cervix, limited to the cervix surface and not extending below the squamous epithelium. Secondary cervical endometriosis is more common than the primary type and describes the disease extensions from the pelvis, or usually the rectovaginal septum. Superficial endometriosis is usually diagnosed by fine-needle aspiration, colposcopy, and cervical biopsy after a routine cervical smear, as endometrial cells detected during a PAP smear may be mistakenly removed as atypical glandular cells. Deep endometriosis may cause pelvic pain, vaginal bleeding, and spotting. In this case report, we present a rare case of cervical endometriosis, characterized by pelvic pain and menstrual irregularity, with endometrioma and adenomyosis, confirmed by histopathological evaluation of the specimen. A summary of the cervical endometriosis cases overview has been made to describe the changing clinical landscape of this rare condition.

摘要

宫颈子宫内膜异位症是一种罕见的子宫内膜异位症形式,通常在子宫切除术或宫颈活检标本的组织病理学评估中偶然诊断出来。尽管有些病例可能无症状,但一些患者的症状从危及生命的出血到严重的慢性盆腔疼痛不等。在无症状患者中,除了观察和随访外,可能不需要进一步干预;然而,有明显症状的患者需要手术。原发性宫颈子宫内膜异位症定义为宫颈前唇有子宫内膜组织,仅限于宫颈表面,不延伸到鳞状上皮以下。继发性宫颈子宫内膜异位症比原发性更常见,描述了从盆腔或通常是直肠阴道隔延伸而来的疾病。浅表性子宫内膜异位症通常通过细针抽吸、阴道镜检查和常规宫颈涂片后的宫颈活检来诊断,因为在 PAP 涂片期间检测到的子宫内膜细胞可能会被误认为是非典型腺细胞而被误除。深部子宫内膜异位症可引起盆腔疼痛、阴道出血和点滴出血。在本病例报告中,我们介绍了一例罕见的宫颈子宫内膜异位症病例,其特征为盆腔疼痛和月经不规则,伴有子宫内膜瘤和腺肌病,通过对标本的组织病理学评估得到证实。对宫颈子宫内膜异位症病例概述进行了总结,以描述这种罕见疾病的临床变化情况。

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