Margolis M T, Thoen L D, Boike G M, Mercer L J, Keith L G
Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA.
Int J Gynaecol Obstet. 1995 Dec;51(3):255-8. doi: 10.1016/0020-7292(95)80022-0.
Endometrial ablation has been recently introduced as a surgical alternative to hysterectomy for the treatment of dysfunctional uterine bleeding. The procedure itself is reasonably safe. However, if occult endometrial cancer is present before the procedure and is not detected, it may be more difficult to diagnose later. Endometrial cancer may also arise de novo from missed endometrial tissue. Two cases of endometrial cancer following endometrial ablation have been reported, but its overall incidence is unknown. A 58-year-old woman was treated with endometrial ablation for dysfunctional uterine bleeding. Three years later she underwent hysterectomy and Marshall-Marchetti-Krantz procedure for urinary incontinence; incidental, asymptomatic endometrial adenocarcinoma was discovered. The final pathology was grade 1 adenocarcinoma, invading more than 50% of the myometrium (FIGO stage Ic). Endometrial cancer may occur following endometrial ablation and it may be asymptomatic. Careful patient selection and close follow-up are essential.
子宫内膜去除术作为子宫切除术的一种手术替代方法，最近被引入用于治疗功能失调性子宫出血。该手术本身相当安全。然而，如果术前存在隐匿性子宫内膜癌而未被检测到，日后可能更难诊断。子宫内膜癌也可能源于遗漏的子宫内膜组织而新发。已有两例子宫内膜去除术后发生子宫内膜癌的病例报告，但总体发病率尚不清楚。一名58岁女性因功能失调性子宫出血接受了子宫内膜去除术。三年后，她因尿失禁接受了子宫切除术和马歇尔 - 马切蒂 - 克兰茨手术；术中偶然发现无症状的子宫内膜腺癌。最终病理结果为1级腺癌，侵犯肌层超过50%（国际妇产科联盟分期Ic期）。子宫内膜去除术后可能发生子宫内膜癌，且可能无症状。仔细选择患者并密切随访至关重要。
