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子宫内膜去分化癌病例报告及其组织病理学特征

Case Report on Dedifferentiated Carcinoma of Endometrium and It's Histopathological Characteristics.

作者信息

Limbachiya Dipak, Tiwari Rajnish, Kumari Rashmi, Trivedi Priti

机构信息

Department of Gynaecological Endoscopy, Eva Women's Hospital, Neelkanth Park 2, Ghoda Camp Road, Shahibaug, Ahmedabad, 380004 India.

出版信息

J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):552-555. doi: 10.1007/s13224-024-02007-2. Epub 2024 Jul 10.

Abstract

The DEAC, a rare entity, has an unfavorable clinical outcome. The role of adjuvant therapy is also controversial in this high-risk variety. The current FIGO grading may also lead to misdiagnosis of DEAC as FIGO grade 2 or 3 endometroid carcinoma, owing to histological insufficiency in assessing the details of solid component within a tumor. The recognition of UC component as a solid patternless growth is extremely important for a correct diagnosis of DEAC. Hereby, a 51-year-old female is presented with chief complaint of postmenopausal bleeding, with D&C report of a poorly differentiated carcinoma of endometrium. Complete comprehensive surgical staging was performed. The final HPE revealed 85-90% UC and 10-15% moderately differentiated endometroid carcinoma, which was finally IHC-proven as well. The disease was found metastatic to adnexa and retroperitoneal lymph nodes. Postoperatively patient was given chemotherapy as adjuvant therapy and she is asymptomatic on follow-up.

摘要

去分化子宫内膜腺癌(DEAC)是一种罕见的疾病,临床预后不佳。在这种高危类型中,辅助治疗的作用也存在争议。由于在评估肿瘤内实性成分细节方面组织学依据不足,目前的国际妇产科联盟(FIGO)分级也可能导致将DEAC误诊为FIGO 2级或3级子宫内膜样癌。将未分化癌(UC)成分识别为无模式的实性生长对于DEAC的正确诊断极为重要。在此,报告一名51岁女性,主要症状为绝经后出血,刮宫术报告为低分化子宫内膜癌。进行了完整的全面手术分期。最终的组织病理学检查显示85 - 90%为UC,10 - 15%为中分化子宫内膜样癌,最终免疫组化也得以证实。发现该疾病已转移至附件和腹膜后淋巴结。术后患者接受了化疗作为辅助治疗,随访时无症状。

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