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病例报告:宫颈旁子宫孤立性纤维瘤合并阴道壁腺癌。

Case report: Solitary fibrous tumor of the paracervical uterus combined with vaginal wall adenocarcinoma.

作者信息

Zhang Xiaowei, Chen Jun, Du Junqiang, Ying Jiajia

机构信息

Department of Pathology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.

Department of Medical Imaging, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.

出版信息

Front Med (Lausanne). 2024 Aug 14;11:1456221. doi: 10.3389/fmed.2024.1456221. eCollection 2024.

Abstract

BACKGROUND

Solitary fibrous tumors are rare mesenchymal tumors that typically occur in the pleura. Solitary fibrous tumors of the uterine cervix are uncommon. We report the first case of a patient who underwent total hysterectomy for vaginal wall adenocarcinoma and was found to have a concurrent solitary fibrous tumor in the paracervical-uterus.

CASE PRESENTATION

A 51-year-old woman was admitted to our hospital due to contact bleeding. A gynecological examination revealed nodules of 3.0 × 1.0 cm on the vaginal wall, and a colposcopy with biopsy revealed adenocarcinoma of the vaginal wall. After the recommended staging examinations, the patient underwent total hysterectomy, double adnexectomy, pelvic lymph node dissection, and vaginal wall resection. During surgery, a nodule measuring approximately 2 × 2 cm was found in the middle of the mass in the left paracervical region. Subsequent postoperative histopathological examination confirmed an solitary fibrous tumor of the uterine cervix with adenocarcinoma of the vaginal wall. The patient was followed up for 46 months after hospitalization, and no recurrence or distant metastases were observed.

CONCLUSION

In rare cases, solitary fibrous tumors may form large masses in the cervical or vaginal wall. They can easily be misdiagnosed as benign or malignant cervical tumors before and during surgery. Postoperative pathology and immunohistochemistry are helpful for diagnosis. Most solitary fibrous cervical tumors are benign, occasionally with low malignant potential, and surgical treatment is feasible and effective.

摘要

背景

孤立性纤维瘤是一种罕见的间叶组织肿瘤,通常发生于胸膜。宫颈孤立性纤维瘤并不常见。我们报告首例因阴道壁腺癌接受全子宫切除术的患者,术中发现宫颈旁子宫同时存在孤立性纤维瘤。

病例介绍

一名51岁女性因接触性出血入院。妇科检查发现阴道壁有3.0×1.0cm的结节,阴道镜检查及活检显示为阴道壁腺癌。在完成推荐的分期检查后,患者接受了全子宫切除术、双侧附件切除术、盆腔淋巴结清扫术及阴道壁切除术。术中,在左侧宫颈旁肿物中部发现一个约2×2cm的结节。术后病理组织学检查证实为宫颈孤立性纤维瘤合并阴道壁腺癌。患者住院后随访46个月,未观察到复发或远处转移。

结论

在罕见情况下,孤立性纤维瘤可在宫颈或阴道壁形成较大肿物。术前及术中易被误诊为良性或恶性宫颈肿瘤。术后病理及免疫组化有助于诊断。大多数宫颈孤立性纤维瘤为良性,偶尔有低恶性潜能,手术治疗可行且有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c826/11349547/047481cb80a1/fmed-11-1456221-g001.jpg

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