Kanemura Akiko, Morisada Tohru, Momomura Mai, Asano Fumio, Shibuya Hiromi, Matsumoto Hironori, Nagahama Kiyotaka, Shibahara Junji, Kobayashi Yoichi
Department of Obstetrics and Gynecology, Faculty of Medicine, Kyorin University, Tokyo, Japan.
Department of Pathology, Faculty of Medicine, Kyorin University, Tokyo, Japan.
Case Rep Obstet Gynecol. 2024 Oct 22;2024:1907965. doi: 10.1155/2024/1907965. eCollection 2024.
In this case, a 66-year-old female patient presented with the chief complaint of abdominal distention. Computed tomography and magnetic resonance imaging revealed no enlarged ovaries or obvious primary lesions; however, massive ascites and peritoneal disseminated nodules were observed. Ascites cytology revealed adenocarcinoma and immunohistochemical findings suggested serous carcinoma. The patient then underwent tumor reduction surgery after preoperative chemotherapy for suspected Stage IIIC primary peritoneal carcinoma. Postoperative histopathology revealed carcinoma consisting mainly of high-grade serous carcinoma (HGSC) and sarcoma. In addition, serous intraepithelial carcinoma (STIC) of the fallopian tube was observed in the fimbriae of the left fallopian tube. Recently, it has been noted in the literature that most cases of peritoneal carcinoma are metastases or dissemination of carcinoma originating from the fimbriae of the fallopian tube. This is a rare case of peritoneal carcinosarcoma with STIC, and its report leads to a better understanding of the disease's features and possible therapeutic approaches.
在该病例中，一名66岁女性患者以腹胀为主诉就诊。计算机断层扫描和磁共振成像显示卵巢未增大，也无明显原发病变；然而，观察到大量腹水和腹膜播散性结节。腹水细胞学检查显示为腺癌，免疫组化结果提示为浆液性癌。该患者随后因疑似IIIC期原发性腹膜癌在术前化疗后接受了肿瘤细胞减灭术。术后组织病理学显示癌主要由高级别浆液性癌（HGSC）和肉瘤组成。此外，在左输卵管伞端观察到输卵管浆液性上皮内癌（STIC）。最近，文献中指出大多数腹膜癌病例是起源于输卵管伞端的癌转移或播散。这是一例罕见的伴有STIC的腹膜癌肉瘤病例，其报告有助于更好地了解该疾病的特征和可能的治疗方法。
