国际妇产科学杂志 ›› 2023, Vol. 50 ›› Issue (3): 306-308.doi: 10.12280/gjfckx.20220810

• 妇科肿瘤研究:病例报告 • 上一篇    下一篇

子宫内膜血管肉瘤一例并文献复习

林志明, 许飞雪()   

  1. 730000 兰州大学第一临床医学院(林志明);兰州大学第一医院妇产科(许飞雪)
  • 收稿日期:2022-10-06 出版日期:2023-06-15 发布日期:2023-06-27
  • 通讯作者: 许飞雪,E-mail:xfx.sxq@163.com

Endometrial Angiosarcoma: A Case Report and Literature Review

LIN Zhi-ming, XU Fei-xue()   

  1. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China (LIN Zhi-ming); Department of Obstetrics and Gynecology, The First Hospital of Lanzhou University, Lanzhou 730000, China (XU Fei-xue)
  • Received:2022-10-06 Published:2023-06-15 Online:2023-06-27
  • Contact: XU Fei-xue, E-mail: xfx.sxq@163.com

摘要:

子宫内膜血管肉瘤是一种临床比较罕见的间质性肉瘤,其临床症状不典型,诊断相对困难,确诊主要依据组织活检,目前尚无标准的治疗方案。报道1例子宫内膜血管肉瘤患者的诊治情况。患者因阴道异常出血1个月余就诊,期间出血量多于平时月经量。入院后完善专科查体、妇科超声及盆腔磁共振成像等检查,综合外院诊断性刮宫子宫内膜病理切片,考虑子宫内膜肉瘤。行广泛性子宫切除术+双侧附件切除术+盆腔淋巴结切除术+腹主动脉旁淋巴结活检术。术后病理示子宫内膜血管肉瘤,临床分期ⅢC1期,术后患者未行辅助治疗,术后5个月复查考虑复发转移。子宫内膜血管肉瘤术后复发时间短且具有远处转移的风险,术后辅助性放化疗、免疫治疗及靶向治疗可以提高患者的存活率。

关键词: 子宫内膜肿瘤, 血管肉瘤, 活组织检查, 免疫组织化学, 治疗

Abstract:

Endometrial angiosarcoma is a rare interstitial sarcoma in clinic. Its clinical symptoms are atypical and diagnosis is relatively difficult. The diagnosis is mainly based on tissue biopsy. There is no standard treatment. The diagnosis and treatment of one case of endometrial angiosarcoma was reported. The patient was treated for abnormal vaginal bleeding for more than 1 month, during which the blood loss was more than the usual menstrual volume. After admission, specialized physical examination, gynecological ultrasound and pelvic magnetic resonance imaging were performed, and endometrial sarcoma was considered based on the diagnostic endometrial curettage pathological section of other hospital. Extensive hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy and para-aortic lymph node biopsy were performed. Postoperative pathology showed endometrial angiosarcoma with clinical stage ⅢC1. The patient did not undergo adjuvant treatment after the operation, and was reviewed 5 months after the operation to consider recurrence and metastasis. The postoperative recurrence time of endometrial angiosarcoma is short and there is a risk of distant metastasis. Postoperative adjuvant chemoradiotherapy, immunotherapy and targeted therapy after surgery can improve the survival rate of patients.

Key words: Endometrial neoplasms, Hemangiosarcoma, Biopsy, Immunohistochemistry, Therapy