Ying A J, Copeland L J, Hameed A
Department of Pathology, Ohio State University Medical Center, Columbus 43210, USA.
Gynecol Oncol. 1998 Mar;68(3):301-3. doi: 10.1006/gyno.1998.4952.
Cutaneous endometriosis infrequently arises in the absence of pelvic disease. Rare features such as myxoid change can resemble malignancy and may pose a challenging histological diagnosis. We are not aware of any previous cases involving nondecidualized cutaneous endometriosis with myxoid change associated with an abdominal surgical scar. We report the first such case in which a 24-year-old woman presented with a steadily growing, firm, tender, painful, subcutaneous cicatrical mass that had appeared shortly after cesarean section 1 year previously. The mass was removed and permanent sections revealed foci of large, irregular endometrial glands embedded within prominent myxoid stroma and acellular mucin pools, with fibrosis and pseudoinfiltration of the fascia. No evidence of malignancy was identified. This case demonstrates that nondecidualized cutaneous endometriosis with myxoid change should be considered in the differential diagnosis of histologically similar malignancies such as mucinous adenocarcinoma and pseudomyxoma peritonei.
皮肤子宫内膜异位症很少在没有盆腔疾病的情况下出现。黏液样改变等罕见特征可能类似恶性肿瘤,可能带来具有挑战性的组织学诊断。我们不知道之前有任何涉及非蜕膜化皮肤子宫内膜异位症伴黏液样改变且与腹部手术瘢痕相关的病例。我们报告首例此类病例,一名24岁女性出现一个持续生长、质地坚硬、触痛、疼痛的皮下瘢痕性肿块,该肿块在1年前剖宫产术后不久出现。肿块被切除,永久切片显示大的、不规则的子宫内膜腺体灶嵌入显著的黏液样间质和无细胞黏液池中,伴有筋膜纤维化和假浸润。未发现恶性证据。该病例表明,在对组织学上类似的恶性肿瘤如黏液腺癌和腹膜假黏液瘤进行鉴别诊断时,应考虑非蜕膜化皮肤子宫内膜异位症伴黏液样改变。