Tabuchi Keiko, Kurihara Shuichi, Takasugi Atsushi, Mizuno Yosuke, Oshiro Yumi
Department of Obstetrics and Gynecology, Saiseikai Fukuoka General Hospital, Fukuoka, JPN.
Department of Obstetrics and Gynecology, Japanese Red Cross Matsuyama Hospital, Matsuyama, JPN.
Cureus. 2025 Feb 17;17(2):e79149. doi: 10.7759/cureus.79149. eCollection 2025 Feb.
An increasing number of case reports have been published regarding the occurrence of extra-endometrial epithelial tumors of the uterine corpus. The majority of these cases are endometrial cancers arising in adenomyosis (EC-AIA). This report describes the case of a postmenopausal woman who presented with a cystic tumor measuring 15 cm in diameter in the pelvic cavity. Prior to surgery, the tumor was considered to be a malignant ovarian cystic tumor with solid components based on imaging studies. A laparotomy was performed, revealing an intramural tumor of the uterine corpus. The intraoperative frozen section diagnosis was inconclusive. Consequently, a hysterectomy with bilateral salpingo-oophorectomy was performed without additional staging procedures. The final histopathological examination by permanent section revealed that the tumor was histologically composed of clear cell carcinoma, accompanied by adenomyotic foci in the surrounding myometrium. It is noteworthy that while most uterine intramural tumors are mesenchymal in nature, intramural extra-endometrial epithelial tumors such as EC-AIA can also manifest as uterine intramural tumors.
关于子宫体部子宫内膜外上皮性肿瘤的发生，已发表了越来越多的病例报告。这些病例大多数是子宫腺肌病中发生的子宫内膜癌（EC-AIA）。本报告描述了一名绝经后女性的病例，该女性盆腔内出现一个直径为15 cm的囊性肿瘤。手术前，根据影像学检查，该肿瘤被认为是一个具有实性成分的恶性卵巢囊性肿瘤。进行了剖腹手术，发现是子宫体部的壁间肿瘤。术中冰冻切片诊断不明确。因此，未进行额外的分期程序，直接进行了子宫切除术及双侧输卵管卵巢切除术。最终的永久切片组织病理学检查显示，肿瘤在组织学上由透明细胞癌组成，周围肌层伴有子宫腺肌病病灶。值得注意的是，虽然大多数子宫壁间肿瘤本质上是间叶性的，但像EC-AIA这样的壁间子宫内膜外上皮性肿瘤也可表现为子宫壁间肿瘤。
