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多面性宫颈子宫内膜异位症:一例复杂妇科病例的术后诊断

Multifaceted Cervical Endometriosis: A Post-Surgical Diagnosis in a Complex Gynecological Case.

作者信息

Wang Qingyuan, Shan Wenjun, Zhu Qiyin, Wang Wenyan

机构信息

Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

出版信息

Am J Case Rep. 2024 Dec 23;25:e945246. doi: 10.12659/AJCR.945246.

Abstract

BACKGROUND Endometriosis is a condition where uterine lining tissue grows outside the uterine cavity, commonly on the ovaries and pelvic peritoneum, but can also occur in rare locations such as the cervix, lungs or pleura. Cervical endometriosis is typically diagnosed retrospectively through post-surgical pathology as it was in this case. This article presents a case of cervical endometriosis with recurrent vaginal bleeding, reviews recent literature to aid in clinical diagnosis and treatment. CASE REPORT A 42-year-old woman presented with a 5-year history of recurrent vaginal bloody discharge. Clinical evaluations revealed a cyst on the posterior wall of the cervix, suspected to be an endometriotic cyst, along with a uterine diverticulum and an endometrial polyp. The patient underwent surgical excision of the cyst, repair of the uterine diverticulum, and removal of the endometrial polyp. Postoperative pathology confirmed the diagnosis of an endometriotic cyst of the cervix. The patient was subsequently treated with oral Dienogest. An 8-month follow-up showed no complaints of discomfort, with gynecological examinations indicating good recovery and no abnormalities detected on ultrasound. CONCLUSIONS Cervical endometriotic cysts are rare but can lead to serious complications if not properly diagnosed and managed. Clinicians should remain vigilant for abnormal symptoms such as recurrent vaginal bleeding and pelvic pain. Timely and appropriate treatment measures, including surgical intervention and hormonal therapy, should be implemented to reduce the risk of complications and monitor for potential malignant transformation. Regular follow-ups are crucial to ensure early detection of any recurrence or progression.

摘要

背景

子宫内膜异位症是一种子宫内膜组织生长在子宫腔外的疾病,常见于卵巢和盆腔腹膜,但也可能发生在宫颈、肺或胸膜等罕见部位。宫颈子宫内膜异位症通常像本例一样通过术后病理进行回顾性诊断。本文介绍了一例伴有反复阴道出血的宫颈子宫内膜异位症病例,回顾近期文献以辅助临床诊断和治疗。

病例报告

一名42岁女性有5年反复阴道血性分泌物病史。临床评估发现宫颈后壁有一个囊肿,怀疑是子宫内膜异位囊肿,同时还有一个子宫憩室和一个子宫内膜息肉。患者接受了囊肿手术切除、子宫憩室修复及子宫内膜息肉切除。术后病理证实为宫颈子宫内膜异位囊肿。患者随后接受口服地诺孕素治疗。8个月的随访显示无不适主诉,妇科检查表明恢复良好,超声检查未发现异常。

结论

宫颈子宫内膜异位囊肿罕见,但如果诊断和管理不当可导致严重并发症。临床医生应警惕反复阴道出血和盆腔疼痛等异常症状。应实施及时且适当的治疗措施,包括手术干预和激素治疗,以降低并发症风险并监测潜在的恶性转化。定期随访对于确保早期发现任何复发或进展至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1941/11670003/44920479603e/amjcaserep-25-e945246-g001.jpg

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