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结肠子宫内膜样腺癌起源于性腺外子宫内膜异位症罕见的恶性转化。

Endometrioid adenocarcinoma of the colon arising from rare malignant transformation of extra-gonadal endometrioma.

作者信息

Stoklosa Anne, Armbuster Youngeun, Marshall Lila, McDowell Jamie L, Zhang Naixin, Smith Ashlee, Angel Cynthia, Varghese Aaron, Huang Wei, Moore Richard

机构信息

Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA.

出版信息

Gynecol Oncol Rep. 2024 Dec 17;57:101664. doi: 10.1016/j.gore.2024.101664. eCollection 2025 Feb.

Abstract

BACKGROUND

Endometriosis is a common condition with a rare malignant potential. We report a case of a patient with a colon mass who underwent surgery for malignant endometriosis associated cancer.Case: A 70-year-old woman with a pelvic mass who was lost to follow-up for 6 years represented with an enlarging pelvic mass involving the sigmoid colon. The patient underwent colonoscopy which revealed atypical endometrial-type glandular proliferation. She then underwent exploratory laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy, rectosigmoid resection, and creation of end colostomy. Final pathology revealed endometrioid adenocarcinoma arising from colon serosal endometriosis. Observation or systemic chemotherapy were considered, and patient opted for observation.

CONCLUSION

We report a case of malignant intestinal endometriosis. There is limited evidence to support a standardized approach to treatment due to the rare nature of this disease; the patient opted for observation. By understanding the presentation, diagnostic workup, and outcomes of each patient with malignant endometriosis, future research can be guided to ultimately improve patient outcomes.

摘要

背景

子宫内膜异位症是一种常见疾病,但具有罕见的恶变潜能。我们报告一例患有结肠肿块的患者,其接受了恶性子宫内膜异位症相关癌症的手术治疗。

病例

一名70岁女性,盆腔有肿块,失访6年后因盆腔肿块增大伴乙状结肠受累前来就诊。患者接受了结肠镜检查,结果显示为非典型子宫内膜样腺性增生。随后,她接受了剖腹探查术,包括全腹子宫切除术、双侧输卵管卵巢切除术、直肠乙状结肠切除术以及末端结肠造口术。最终病理显示乙状结肠浆膜子宫内膜异位症伴子宫内膜样腺癌。考虑了观察或全身化疗,患者选择了观察。

结论

我们报告了一例恶性肠道子宫内膜异位症病例。由于这种疾病的罕见性,支持标准化治疗方法的证据有限;患者选择了观察。通过了解每例恶性子宫内膜异位症患者的临床表现、诊断检查和治疗结果,可为未来的研究提供指导,最终改善患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a60b/11750269/9417ba751476/gr1.jpg

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