Inoue M, Fukuda H, Tanizawa O
Department of Obstetrics and Gynecology, Osaka University Medical School, Japan.
Int J Gynaecol Obstet. 1995 Mar;48(3):299-306. doi: 10.1016/0020-7292(94)02267-3.
We report three cases of adenosarcomas arising from extraendometrium of the uterus: one arising from the ovary, one from the paracolpium and one from the endocervix of the uterus. Microscopically, they consisted of an admixture of benign-appearing epithelial and mesenchymal components with hypercellularity and minimal atypia. Two of the tumors were initially misdiagnosed as endometriosis and one was diagnosed as adenofibroma. One patient had several recurrences and died 7 years after the initial laparotomy and another patient had sarcomatous overgrowth which invaded the muscular tissues of the large intestine. Thus it appears that adenosarcoma occasionally shows grave clinical behavior, despite the benign or low-grade appearance of its microscopic features. Problems of diagnosis and management of this tumor are discussed. An aggressive therapeutic approach including wide surgical excision is recommended even in questionable cases.
我们报告了3例起源于子宫外膜的腺肉瘤：1例起源于卵巢，1例起源于阴道旁组织，1例起源于子宫颈内膜。显微镜下，它们由外观良性的上皮和间充质成分混合而成，细胞增多，异型性极小。其中2例肿瘤最初被误诊为子宫内膜异位症，1例被诊断为腺纤维瘤。1例患者多次复发，初次剖腹手术后7年死亡，另1例患者肉瘤过度生长，侵犯了大肠肌肉组织。因此，尽管腺肉瘤的显微镜特征表现为良性或低级别，但偶尔也会表现出严重的临床行为。本文讨论了该肿瘤的诊断和治疗问题。即使在可疑病例中，也建议采用包括广泛手术切除在内的积极治疗方法。
