Maassen V, Lampe B, Untch M, Mikorey S, Hepp H, Kindermann G
I. Frauenklinik Klinikum Innenstadt, Universität München.
Geburtshilfe Frauenheilkd. 1993 May;53(5):308-13. doi: 10.1055/s-2007-1022888.
In the United States, vaginal adenosis and clear-cell carcinoma of the vagina were frequently observed in young women, who had been exposed to the synthetic estrogen diethyl-stilbestrol (DES) during their embryonic development. In Germany, obviously, no such exposure occurred. Clearly, such diseases also develop without the context of intrauterine exposure to certain substances. Our own case of such a partly exophytic, partly endophytic adeno-carcinoma of the vagina with multifocal vaginal adenosis, demonstrates the histogenesis, symptoms, diagnostic procedures and therapy of this rare disease. Since young women during their reproductive years are mostly affected, the possibility of fertility-conserving surgery is discussed despite the current practice of radical cancer surgery (with and without radiation). In the 25-year-old patient, we conducted a colpectomy whilst leaving the uterus and ovaries, and replaced the vaginal defect by a sigmoid transplant anastomosed to the cervix. The patient has regular menstrual cycles, should, however, not become pregnant for 1 to 2 years for oncological reasons.
在美国，阴道腺病和阴道透明细胞癌常见于在胚胎发育期间接触过合成雌激素己烯雌酚（DES）的年轻女性。显然，在德国没有发生过此类接触情况。很明显，此类疾病也会在没有子宫内接触某些物质的情况下发生。我们自己遇到的一例部分外生性、部分内生性阴道腺癌伴多灶性阴道腺病的病例，展示了这种罕见疾病的组织发生、症状、诊断方法及治疗情况。由于生殖年龄段的年轻女性受影响居多，尽管目前的癌症根治手术（有或无放疗）是通行做法，但仍讨论了保留生育功能手术的可能性。对于这位25岁的患者，我们实施了阴道切除术，同时保留子宫和卵巢，并通过将一段乙状结肠移植吻合至宫颈来修复阴道缺损。该患者月经周期规律，不过，出于肿瘤学原因，1至2年内不应怀孕。
