Wroclaw Comprehensive Cancer Center, Wroclaw, Poland.
Lower Silesian Specialist Hospital, Wroclaw, Poland.
Medicine (Baltimore). 2023 Jul 28;102(30):e34387. doi: 10.1097/MD.0000000000034387.
Leiomyomas are the most common benign tumors of smooth muscle origin in women. They are most frequently found in the submucosal tissue of the uterine corpus; however, they also occur in other areas of the uterus, including the cervix. Their size usually varies between 0.5 to 1.0 cm; however, they can reach great dimensions. A strong correlation between the onset and growth of leiomyomas and estrogen levels was observed. Granulosa cell tumor (GCT) is an infrequent sex cord-stromal ovarian neoplasm. Despite their malignancy, GCTs have a good long-term prognosis. In this study, we present a unique case of coincidence of 2 tumors: leiomyoma of rare location (cervix uteri) and extraordinary size (9, 04 cm diameter) with an adult granulosa cell tumor.
A 67-year-old Caucasian woman was transported from an emergency ward to a gynecological surgery department due to a massive vaginal hemorrhage.
Preliminary examination showed a presence of an enormous uteri cervix tumor.
Initially, the patient underwent physical and ultrasound examinations. To prevent further bleeding, an urgent surgery (hysterectomy) with bilateral salpingo-oophorectomy was performed.
Postoperative histopathological examination revealed a cervical leiomyoma and the incidental occurrence of an adult GCT in the right ovary.
This case shares an interesting coincidence between a rare variant of leiomyoma and GCT. The study suggests that the potential reason for this can be estrogen secreted by the GCT, which causes the enormous size of the patient's cervical leiomyoma and the severe vaginal bleeding. Therefore, we advise it is important in abnormal cases to search for other hidden explanations, as in cases of GCT.
平滑肌瘤是女性最常见的良性平滑肌来源肿瘤。它们最常发生于子宫体的黏膜下组织；然而，它们也发生于子宫的其他部位，包括子宫颈。它们的大小通常在 0.5 至 1.0 厘米之间变化；然而，它们也可以达到很大的尺寸。平滑肌瘤的发生和生长与雌激素水平之间存在很强的相关性。颗粒细胞瘤（GCT）是一种罕见的性索-间质卵巢肿瘤。尽管它们具有恶性，但 GCT 具有良好的长期预后。在本研究中，我们报告了一个独特的病例，即罕见部位（子宫颈）和巨大尺寸（9.04 厘米直径）的平滑肌瘤与成人颗粒细胞瘤同时发生。
一位 67 岁的白种妇女因大量阴道出血从急诊病房被送往妇科外科病房。
初步检查显示子宫颈有一个巨大的肿瘤。
最初，患者接受了体格检查和超声检查。为了防止进一步出血，紧急进行了手术（子宫切除术）和双侧输卵管卵巢切除术。
术后组织病理学检查显示宫颈平滑肌瘤和右侧卵巢偶然发生的成人 GCT。
这个病例分享了平滑肌瘤罕见变异和 GCT 之间有趣的巧合。研究表明，这种情况的潜在原因可能是 GCT 分泌的雌激素导致患者宫颈平滑肌瘤的巨大尺寸和严重的阴道出血。因此，我们建议在异常情况下，像 GCT 一样，寻找其他隐藏的解释非常重要。
