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子宫绒毛膜癌合并子宫内膜腺癌:病例报告及文献复习。

Uterine choriocarcinoma coexistence with endometroid adenocacinoma: a case report and literature review.

机构信息

Department of Gynaecology and Obstetrics, West China Second Hospital, Sichuan University, 3 Section of People South Street, Chengdu, 610041, P. R. China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.

出版信息

BMC Womens Health. 2023 May 10;23(1):252. doi: 10.1186/s12905-023-02377-1.

Abstract

BACKGROUND

Choriocarcinoma coexisting with endometrial carcinoma is rare. To the best of our knowledge, only one case of choriocarcinoma coexisting with endometrial carcinoma has been reported.

CASE PRESENTATION

Here, we present this case and provide a literature review. A 38-year-old unmarried nulliparous woman presented to the clinic with a menstrual disorder for more than 3 months. She then underwent a hysteroscopic procedure. The pathological findings were malignant, two types of carcinoma, and no transitional lesions were observed; about 85% of them were choriocarcinoma with smooth muscle infiltration and intravascular investigation of the thrombus; about 15% were highly differentiated endometrioid adenocarcinoma; Immunohistochemistry (endometrioid/choriocarcinoma): Vim (+ + / +  + +), P40 (+ ±), CK5/6 multifocal ( ±), CK7 ( ±), EMA (+ ±), P16 multifocal ( ±), P53 (+ / + +), WT-1 (-/ + +), hCG (-/ +  + +), CD138 (-/ +  + +), Gly-3 (-/-), ER ( ±), PR (+ ±), Sall-4 (-/-), P21 (-/ +), P27 (-/ +  + +), CyclinE (-/ + +), Ki67 positivity rate (10%/95%). We performed a laparoscopic hysterectomy, bilateral adnexectomy, and pelvic and para-abdominal lymph node dissection after five cycles of chemotherapy. She was diagnosed with choriocarcinoma with endometrial cancer, stage IVb choriocarcinoma and stage IA endometrial cancer. Postoperative radiochemotherapy was administered. The patient was disease-free 40 months after the treatment ended.

CONCLUSION

We report a case of choriocarcinoma coexisting with endometrial carcinoma and provide a literature review that may help inspire additional studies in the future.

摘要

背景

绒毛膜癌合并子宫内膜癌较为罕见。据我们所知,仅有 1 例绒毛膜癌合并子宫内膜癌的病例报告。

病例介绍

在此,我们报告 1 例病例并进行文献复习。1 名 38 岁未婚未育女性因月经紊乱 3 个多月就诊,行宫腔镜检查。病理检查结果为恶性,两种类型的癌,未见移行病变;绒毛膜癌占 85%左右,伴平滑肌浸润和血栓内血管浸润;子宫内膜样腺癌占 15%左右,高分化;免疫组化(子宫内膜样癌/绒毛膜癌):Vim(+++/++++),P40(+±),CK5/6 灶性(±),CK7(±),EMA(+±),P16 灶性(±),P53(+/+++),WT-1(-/+++),hCG(-/++++),CD138(-/++++),Gly-3(-/-),ER(±),PR(+±),Sall-4(-/-),P21(-/+++),P27(-/++++),CyclinE(-/+++),Ki67 阳性率 10%/95%。患者接受 5 个周期化疗后,行腹腔镜子宫切除术、双侧附件切除术及盆腔和腹主动脉旁淋巴结清扫术。患者诊断为绒毛膜癌合并子宫内膜癌,IVb 期绒毛膜癌和 IA 期子宫内膜癌。术后行放化疗。患者治疗结束后 40 个月无疾病。

结论

我们报告了 1 例绒毛膜癌合并子宫内膜癌病例,并进行了文献复习,可能有助于未来开展更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1531/10173573/c469fab94e46/12905_2023_2377_Fig1_HTML.jpg

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