Kannan Mahalakshmi, Devarajan Mohanapriya, Vasudevan Sudha
Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Pathology and Laboratory Medicine, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2023 Dec 17;15(12):e50676. doi: 10.7759/cureus.50676. eCollection 2023 Dec.
This study is a retrospective review of data from patients who were incidentally diagnosed with endometrial stromal sarcoma after a routine hysterectomy for uterine fibroid at the Department of Gynaecologic Oncology in a tertiary care hospital. The Institutional Review Board (IRB) gave its clearance for this study before it was carried out. Informed written consent was obtained from all patients. In our case series, the three patients presented with complaints of menorrhagia, lower abdominal pain, intermenstrual bleeding, and acute retention of urine. After the patients underwent a clinical examination and radiological scan, the diagnosis of fibroids was made. They underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histology revealed low-grade endometrial stromal sarcoma (LGESS). The patients were observed for adjuvant therapy. The patients had a follow-up period of 18-24 months. In LGESS, which is rare, prompt management is of utmost importance, because the tumour's stage is the most significant predictor of the prognosis. As there are no clear indications to suggest the presence of LGESS prior to the histopathology of the specimen, it is necessary to analyze the data of patients who are diagnosed with LGESS, in order to investigate and manage the condition more appropriately. After myomectomy for a suspected leiomyoma, there is a 0.2% chance of the result showing endometrial stromal sarcoma.
本研究是一项回顾性研究,数据来自于在一家三级护理医院的妇科肿瘤科室因子宫肌瘤行常规子宫切除术后偶然诊断为子宫内膜间质肉瘤的患者。在开展本研究之前,机构审查委员会(IRB)已批准该研究。所有患者均获得了知情书面同意。在我们的病例系列中,三名患者表现出月经过多、下腹痛、经间期出血和急性尿潴留的症状。患者经过临床检查和影像学扫描后,被诊断为子宫肌瘤。他们接受了全腹子宫切除术及双侧输卵管卵巢切除术。组织学检查显示为低级别子宫内膜间质肉瘤(LGESS)。对患者进行了辅助治疗观察。患者的随访期为18至24个月。在罕见的LGESS中,及时处理至关重要,因为肿瘤分期是预后的最重要预测因素。由于在标本组织病理学检查之前没有明确迹象提示LGESS的存在,因此有必要分析被诊断为LGESS的患者数据,以便更恰当地研究和处理该疾病。在对疑似平滑肌瘤进行肌瘤切除术后,结果显示为子宫内膜间质肉瘤的几率为0.2%。