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一例罕见的卵巢转移癌术后小肠癌伴子宫转移病例，通过免疫染色确诊

A Rare Case of Small Intestinal Cancer With Uterine Metastasis After Surgery for Ovarian Metastasis, Diagnosed Using Immunostaining.

作者信息

Nagao Sachiko, Matsuura Motoki, Kurokawa Shoko, Tamate Masato, Akimoto Taishi, Saito Tsuyoshi

机构信息

Department of Obstetrics and Gynecology Sapporo Medical University, Sapporo, Hokkaido, Japan.

出版信息

Case Rep Oncol Med. 2024 Aug 10;2024:8551816. doi: 10.1155/2024/8551816. eCollection 2024.

DOI:10.1155/2024/8551816
PMID:39156866
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11330332/
Abstract

Uterine metastases from extragenital sites are rare. We present a case of a woman who had undergone surgery for small intestinal cancer and subsequently developed metastases in her left ovary and uterus. A nulliparous woman in her 50s underwent laparoscopic partial small bowel resection with lymph node dissection for small intestinal cancer. Five months later, computed tomography (CT) revealed a left ovarian tumor and ascites. She underwent bilateral adnexectomy and adjuvant chemotherapy, and the ovarian tumor was diagnosed as a small intestinal cancer metastasis. Two years after the small intestinal cancer surgery, a positron emission tomography (PET)-CT scan revealed a uterine accumulation. Cervical cytology was negative for intraepithelial lesion or malignancy. Endometrial histology showed an adenocarcinoma of the uterus. The patient underwent total abdominal hysterectomy followed by adjuvant chemotherapy. Histopathology and immunohistochemistry of the uterine tumor revealed that it was a metastasis of small intestinal cancer (Cytokeratin 7 [CK7] [-], Cytokeratin 20 [CK20] [+], Special AT-Rich Sequence-Binding Protein 2 [SATB2] [+], Paired Box Gene 2 [PAX2] [-], and estrogen receptor [ER] [-]). In patients with cancer, histopathology and immunohistochemistry are important for distinguishing between primary and metastatic tumors and for guiding the choice of treatment.

摘要

来自生殖器外部位的子宫转移瘤罕见。我们报告一例女性患者，她曾接受小肠癌手术，随后左卵巢和子宫出现转移瘤。一名50多岁未生育的女性因小肠癌接受了腹腔镜下部分小肠切除术及淋巴结清扫术。五个月后，计算机断层扫描（CT）显示左卵巢肿瘤及腹水。她接受了双侧附件切除术及辅助化疗，卵巢肿瘤被诊断为小肠癌转移瘤。小肠癌手术后两年，正电子发射断层扫描（PET）-CT显示子宫有放射性浓聚。宫颈细胞学检查未发现上皮内病变或恶性肿瘤。子宫内膜组织学检查显示为子宫腺癌。患者接受了全腹子宫切除术及辅助化疗。子宫肿瘤的组织病理学和免疫组化检查显示为小肠癌转移瘤（细胞角蛋白7 [CK7] [-]，细胞角蛋白20 [CK20] [+]，富含AT序列结合蛋白2 [SATB2] [+]，配对盒基因2 [PAX2] [-]，雌激素受体 [ER] [-]）。对于癌症患者，组织病理学和免疫组化对于区分原发性肿瘤和转移性肿瘤以及指导治疗选择很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/95f09dd34600/CRIONM2024-8551816.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/c1645e63fe47/CRIONM2024-8551816.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/9066b2ed9272/CRIONM2024-8551816.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/97ec66fefd6b/CRIONM2024-8551816.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/9622d033ee4e/CRIONM2024-8551816.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/95f09dd34600/CRIONM2024-8551816.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/c1645e63fe47/CRIONM2024-8551816.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/9066b2ed9272/CRIONM2024-8551816.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/97ec66fefd6b/CRIONM2024-8551816.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/9622d033ee4e/CRIONM2024-8551816.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6463/11330332/95f09dd34600/CRIONM2024-8551816.005.jpg

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