Eifel P, Hendrickson M, Ross J, Ballon S, Martinez A, Kempson R
Cancer. 1982 Jul 1;50(1):163-70. doi: 10.1002/1097-0142(19820701)50:1<163::aid-cncr2820500131>3.0.co;2-k.
Twenty-nine patients had simultaneous malignant epithelial neoplasms of the uterine corpus and ovary. Three groups were defined on the basis of tumor histology: Group A: those with endometrioid carcinoma in both the uterus and ovary; Group B: those with special variants of corpus carcinoma (papillary, clear cell, mucinous) and identical neoplasms in the ovary; and Group C: those whose uterine and ovarian carcinomas were of dissimilar histologic types. Sixteen women had endometrioid carcinoma in both sites. The median age at diagnosis, 41 years, was younger than is usual for corpus or ovarian cancer. For all 16 patients, the grade of the ovarian endometrioid carcinoma was similar to that of the endometrioid carcinoma of the uterine corpus. Seven patients had bilateral ovarian neoplasms. Only one patient had myometrial invasion by the corpus carcinoma. No patient with simultaneous ovarian and uterine endometrioid carcinoma, regardless of grade, has died of cancer although one vaginal relapse was treated successfully. This excellent survival of patients with simultaneous endometrioid carcinomas is better than would be expected for either Stage III adenocarcinoma of the endometrium or Stage II ovarian carcinoma. These simultaneously occurring endometrioid neoplasms of ovary and endometrium are considered to be separate primary tumors. The morphologic reasons for this view and therapeutic implications are discussed. In contrast to the patients with endometrioid carcinoma, the eleven patients with other histologic types of carcinoma in the ovary and corpus were older (median age, 61 years) and more often postmenopausal (90%). These neoplasms were more aggressive, with frequent deep myometrial involvement (63%), tubal involvement (27%), and extension to other pelvic tissues (36%) at the time of initial diagnosis. Six of these 11 patients succumbed to their cancer despite surgical therapy and radiation. The distribution of tumor in some of these patients with nonendometrioid types of carcinoma is suggestive of a single primary with metastases. The therapeutic implications of these findings are discussed.
29例患者同时患有子宫体和卵巢的恶性上皮性肿瘤。根据肿瘤组织学将患者分为三组：A组：子宫和卵巢均为子宫内膜样癌；B组：子宫体癌为特殊类型（乳头状、透明细胞、黏液性）且卵巢为相同肿瘤；C组：子宫癌和卵巢癌组织学类型不同。16名女性两个部位均为子宫内膜样癌。诊断时的中位年龄为41岁，比子宫癌或卵巢癌的常见诊断年龄要小。对于所有16例患者，卵巢子宫内膜样癌的分级与子宫体子宫内膜样癌相似。7例患者双侧卵巢有肿瘤。仅1例患者子宫体癌侵犯肌层。同时患有卵巢和子宫子宫内膜样癌的患者，无论分级如何，均无死于癌症者，尽管有1例阴道复发经成功治疗。同时发生子宫内膜样癌患者的这种良好生存率优于子宫内膜III期腺癌或卵巢II期癌的预期生存率。这些同时发生的卵巢和子宫内膜样肿瘤被认为是独立的原发性肿瘤。本文讨论了支持该观点的形态学原因及治疗意义。与子宫内膜样癌患者不同，卵巢和子宫体为其他组织学类型癌的11例患者年龄较大（中位年龄61岁），绝经后患者更多（90%）。这些肿瘤侵袭性更强，初诊时经常有肌层深部浸润（63%）、输卵管受累（27%）及扩散至其他盆腔组织（36%）。这11例患者中有6例尽管接受了手术治疗和放疗仍死于癌症。部分非子宫内膜样癌类型患者的肿瘤分布提示为单一原发性肿瘤伴转移。本文讨论了这些发现的治疗意义。
