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成功妊娠案例报告及文献复习:16 年后无复发,单独接受活检和化疗的宫颈胚胎性横纹肌肉瘤女性

Successful pregnancy in a female with embryonal rhabdomyosarcoma of the cervix who received biopsy and chemotherapy alone without recurrence after 16 years: a case report and literature review.

机构信息

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Number 20, 3rd section, South Renmin Road, Chengdu, 610041, Sichuan, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Number 17, 3rd section, South Renmin Road, Chengdu, 610041, Sichuan, China.

出版信息

BMC Womens Health. 2023 Sep 1;23(1):466. doi: 10.1186/s12905-023-02623-6.

Abstract

BACKGROUND

Embryonal rhabdomyosarcoma (ERMS) of the uterine cervix is rare, but the population affected is mostly underage females. The scope of surgery has now evolved from extensive to limited, and organ-preserving surgery combined with chemotherapy is recommended to preserve the patient's fertility. However, reports of birth outcomes are rare.

CASE

A minor woman with cervical ERMS who underwent only an outpatient biopsy of the lesion had no residual lesion on subsequent multipoint cervical biopsy and refused radical surgery or cervical conization, after which the patient received a nonclassical regimen of chemotherapy. The patient stopped the chemotherapy on her own, but the patient conceived spontaneously 16 years later with a good pregnancy outcome and no recurrence.

CONCLUSIONS

This case suggests that preservation of reproductive function is often feasible in immature women with cervical ERMS, and the prognosis is usually good as long as the primary tumour can be surgically removed and the lesion is free of residual disease. We also look forward to reports of subsequent growth and pregnancy outcomes in other children with reproductive tract RMS. In cervical ERMS, accurate evaluation of the disease and development of an individualized treatment plan are crucial, and the protection of reproductive function and psychological well-being deserves special attention.

摘要

背景

宫颈胚胎性横纹肌肉瘤(ERMS)较为罕见,但受影响的人群大多为未成年女性。目前手术范围已从广泛转为局限,建议采用保留器官的手术联合化疗,以保留患者的生育能力。然而,关于生育结局的报道较为少见。

病例

一位未成年女性,宫颈 ERMS 患者,仅行病变部位的门诊活检,后续多点宫颈活检未见残留病灶,且拒绝根治性手术或宫颈锥切术,此后该患者接受了非典型的化疗方案。患者自行停止化疗,但 16 年后自然妊娠,妊娠结局良好,无复发。

结论

本病例提示,对于宫颈 ERMS 的未成年女性,保留生育功能通常是可行的,只要能手术切除原发肿瘤且无残留病灶,预后通常较好。我们也期待其他生殖道 RMS 患儿的后续生长和妊娠结局的报道。在宫颈 ERMS 中,准确评估疾病并制定个体化治疗方案至关重要,保护生殖功能和心理健康值得特别关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a7f/10474710/4c2cba71f595/12905_2023_2623_Fig1_HTML.jpg

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