Jiang Q C
Shanghai the First People's Hospital.
Zhonghua Fu Chan Ke Za Zhi. 1993 Jun;28(6):340-2, 380-1.
Eight cases of malignant tumors arising from endometriosis were reported; the ovary was the primary site in 7, whereas extragonadal site (rectum) in 1. The histologic classification was as follows: endometrioid carcinoma in 1. Clear cell carcinoma in 2, mixed clear cell carcinoma and endometrioid carcinoma in 2, mixed papillary cystadenocarcinoma in 1 and serous tumor of borderline malignancy in 1. The histologic pattern arising from endometriosis of the rectal wall was endometrioid adenocarcinoma with benign endometriosis contiguous to it. It was found that the ectopic endometrial tissue may undergo malignant change when they were under stimulation by some factors. One of which may be intrinsic or extrinsic estrogen, which may be related to the high incidence rate in this age group. Laparotomy should be done for assessing malignant change when ovarian mass was greater than 10 cm or grew rapidly. Five year survival rate will be expected to improved with postoperative progestin or irradiation. Preventive measures were also suggested.
报告了8例源自子宫内膜异位症的恶性肿瘤;7例原发部位在卵巢,1例在性腺外部位(直肠)。组织学分类如下:子宫内膜样癌1例,透明细胞癌2例,透明细胞癌与子宫内膜样癌混合2例,混合性乳头状囊腺癌1例,交界性浆液性肿瘤1例。直肠壁子宫内膜异位症产生的组织学类型为子宫内膜样腺癌,与之相邻的是良性子宫内膜异位症。发现异位子宫内膜组织在某些因素刺激下可能发生恶性变。其中之一可能是内源性或外源性雌激素,这可能与该年龄组的高发病率有关。当卵巢肿块大于10cm或生长迅速时,应进行剖腹手术以评估是否发生恶性变。术后使用孕激素或放疗有望提高5年生存率。还提出了预防措施。