Zichella L, Perrone G, De Falco V, Pelle R, Eleuteri Serpieri D
Policlinico Umberto I, Università degli Studi di Roma La Sapienza.
Minerva Ginecol. 1994 Sep;46(9):511-4.
We describe a case of an endocervical heterologous mesodermal adenosarcoma, found in a 43 year old woman. Among mesodermal neoplasms, various histological types are distinguished: the carcinosarcoma, the embryonal rhabdomyosarcoma or botryoid sarcoma, and the adenosarcoma; the last is formed by a benign epithelial component and by a malignant stromal component, that may contain heterologous tissues, such as cartilage, skeletal muscle, etc. Adenosarcoma is a tumor of the uterine corpus and seems to be most common among menopausal women. A primitive adenosarcoma of the uterine cervix is very rare; in fact the overall percentage of the uterine cervical sarcoma is 0.2-0.4%. The patient, age 43 years, with regular menstrual bleeding came to an outpatient clinic referring a post coital metrorrhagia. After a control examination, a polyp from the uterine cervix was removed; the histopathologic diagnosis was: fibroangioadenomatous polyp of the isthmus with cartilaginous metaplastic areas. Two months later, the patient was referred to our clinic and another cervical polyp was removed. The histological diagnosis was adenosarcoma with chondrosarcomatous heterologous mesodermal component. Then the patient was operated and the postoperative histological examination confirmed the preoperative diagnosis. A literature review about the uterine adenosarcoma etiopathogenesis is reported, and a suitable diagnostic iter, is discussed.
我们描述了一例发生在一名43岁女性身上的宫颈异源性中胚层腺肉瘤病例。在中胚层肿瘤中，可区分出多种组织学类型：癌肉瘤、胚胎性横纹肌肉瘤或葡萄状肉瘤以及腺肉瘤；后者由良性上皮成分和恶性间质成分组成，恶性间质成分可能包含异源性组织，如软骨、骨骼肌等。腺肉瘤是子宫体部的肿瘤，似乎在绝经后女性中最为常见。宫颈原发性腺肉瘤非常罕见；实际上，宫颈肉瘤的总体比例为0.2 - 0.4%。该患者43岁，月经出血规律，因性交后子宫出血前来门诊就诊。经过检查后，切除了宫颈息肉；组织病理学诊断为：峡部纤维血管性腺瘤样息肉伴软骨化生区。两个月后，患者转诊至我们的诊所，又切除了一个宫颈息肉。组织学诊断为腺肉瘤伴软骨肉瘤样异源性中胚层成分。随后患者接受了手术，术后组织学检查证实了术前诊断。报告了关于子宫腺肉瘤病因发病机制的文献综述，并讨论了合适的诊断流程。
