子宫高级别神经内分泌癌合并子宫内膜样腺癌一例

doi:10.12280/gjfckx.20230595

摘要/Abstract

摘要：

子宫高级别神经内分泌癌是一种罕见的子宫恶性肿瘤，恶性程度高，预后差，由于其发病率低，目前尚无标准的治疗方案。报道1例56岁的Ⅳ期子宫高级别神经内分泌癌合并子宫内膜样腺癌患者的诊疗经过。患者经历了手术治疗+1次腹腔化疗+6个疗程全身性化疗（紫杉醇+铂类），接近完全缓解，随后再次进行了2个疗程的巩固化疗，评估患者病情稳定。现随访2年10个月，患者恢复良好，影像学检查未见复发迹象。回顾性分析该病例的临床特点及诊治经过，复习相关文献，以提高对此类疾病的认识。

关键词: 宫颈肿瘤, 癌，神经内分泌, 癌，子宫内膜样, 子宫内膜肿瘤, 抗肿瘤联合化疗方案

Abstract:

High-grade neuroendocrine carcinoma of the uterus is a rare malignant tumor of the uterus with high malignancy and poor prognosis. Due to its low incidence rate, there is no standard treatment at present. Therefore, this paper reports the diagnosis and treatment of a 56-year-old patient with stage Ⅳ uterine high-grade neuroendocrine carcinoma accompanied by endometrioid adenocarcinoma. The patient has undergone surgery, followed by 1 intraperitoneal chemotherapy and 6 courses of systemic chemotherapy (paclitaxel + platinum), then the patient′s outcome was close to complete response. Subsequently, 2 courses of consolidation chemotherapy were performed, and the patient′s condition was evaluated as stable. Currently followed up for 2 years and 10 months, the patient recovered well and did not show obvious signs of recurrence on imaging examination. With retrospective analysis of the clinical characteristics, diagnosis, and treatment of this case as well as relevant literature analysis, this paper aim to improve clinician′s understanding of this type of disease.

Key words: Uterine cervical neoplasms, Carcinoma, neuroendocrine, Carcinoma, endometrioid, Endometrial neoplasms, Antineoplastic combined chemotherapy protocols

沈艳清, 陈烨, 石玉香, 黄增发, 曹莹. 子宫高级别神经内分泌癌合并子宫内膜样腺癌一例[J]. 国际妇产科学杂志, 2023, 50(6): 668-672.

SHEN Yan-qing, CHEN Ye, SHI Yu-xiang, HUANG Zeng-fa, CAO Ying. A Case Report of Uterine High-Grade Neuroendocrine Carcinoma with Endometrioid Adenocarcinoma[J]. Journal of International Obstetrics and Gynecology, 2023, 50(6): 668-672.

图/表 4

图1 术前下腹部、盆腔增强MRI图注：箭头所指为病灶。A为矢状面，子宫病灶。B为横断面，转移性淋巴结。

图2 术前宫腔诊刮组织病理图（HE染色×200）注：标尺=50 μm。

图3 术后肿瘤转移组织（大网膜）病理图（HE染色×100）注：标尺=100 μm。

图4 全腹部MRI横断面图注：箭头所指为肝脏转移灶。A 2020年8月25日，肝脏转移灶，大小约15 mm×20 mm；B 2020年11月24日，肝脏转移灶，直径约4 mm；C 2021年1月13日，肝脏转移灶显示不清；D 2021年4月7日，肝脏转移灶未显示。

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