Horn L C, Fischer U, Reuter S, Pyttel C
Institut für Pathologie, Universität Leipzig.
Zentralbl Gynakol. 1998;120(1):38-41.
Sarcomas represent 2-3% of all gynecologic malignancies, only 10% occur outside the uterus. They are often not diagnosed before they reach an advanced stage. We report on a 56 years old women who had an exulcerated leiomyosarcoma of 8 cm in diameter in the posterior wall of the vagina. Initially she was treated by radiation, but the tumor showed a progressive growth. So she underwent a radical hysterectomy, radical colpectomy and vulvectomy, followed by six courses of adriamycinchemotherapy. 15 years later she is free of disease. Additionally we report on two women of 21- and 41-years of age with leiomyomas on the anterior wall of the vagina. These tumors were enucleated with an unconspicious postoperative follow up. In cases of leiomyosarcomas, which in most cases are located at the posterior wall of the vagina, radical surgery shows the best prognosis. Additionally a chemotherapy with adriamycin or ifosphamid can be used. Before surgery a biopsy is recommended to get a definitive diagnosis and to differentiate between benign and malignant lesions and to plan the optimal surgical strategy. In cases of leiomyomas they should be enucleated, because of the possibility of undergoing malignant change.
肉瘤占所有妇科恶性肿瘤的2% - 3%，仅10%发生在子宫外。它们在进入晚期之前往往难以诊断。我们报告一例56岁女性，其阴道后壁有一个直径8厘米的溃疡型平滑肌肉瘤。最初她接受了放疗，但肿瘤仍呈进行性生长。于是她接受了根治性子宫切除术、根治性阴道切除术和外阴切除术，随后进行了六个疗程的阿霉素化疗。15年后她无病生存。此外，我们还报告了两名分别为21岁和41岁的女性，她们的阴道前壁有平滑肌瘤。这些肿瘤被摘除，术后随访情况良好。对于平滑肌肉瘤，大多数位于阴道后壁，根治性手术预后最佳。此外，可使用阿霉素或异环磷酰胺进行化疗。手术前建议进行活检以明确诊断，区分良性和恶性病变，并制定最佳手术策略。对于平滑肌瘤，应将其摘除，因为存在恶变的可能性。
