子宫内膜癌合并子宫腺肌病癌变一例及文献复习

doi:10.12280/gjfckx.20220282

摘要/Abstract

摘要：

子宫内膜癌合并子宫腺肌病癌变临床罕见，无特异性临床表现，多依靠术后病理明确诊断，其治疗多依据子宫内膜癌的治疗原则，预后尚不清楚。报告了1例57岁因绝经后阴道出血就诊的女性患者，彩色超声提示子宫腺肌病，子宫内膜厚9 mm，诊断性刮宫病理提示子宫内膜样腺癌，进一步行子宫内膜癌全面分期术，术后病理提示子宫内膜腺癌合并子宫腺肌病癌变。术后诊断为子宫内膜癌Ⅰa期合并子宫腺肌病癌变，术后定期随访，未见复发征象。

关键词: 子宫内膜肿瘤, 子宫腺肌病, 治疗, 预后, 病例报告

Abstract:

Endometrial cancer complicated with adenomyosis canceration is a rare disease with no specific clinical manifestations. The diagnosis is mostly determined by postoperative pathology, and its treatment is mostly based on the treatment principles of endometrial cancer. The prognosis is still unclear. We report a 57-year-old woman who presented for postmenopausal vaginal bleeding. Color Doppler ultrasound suggested adenomyosis with endometrium thickness of 9 mm, and curettage pathology suggested endometrioid adenocarcinoma. Further comprehensive staging of endometrial cancer was performed. Postoperative pathology revealed endometrial adenocarcinoma with adenomyosis canceration. The patient was diagnosed as stage Ⅰa endometrial cancer complicated with adenomyosis malignant transformation. Regular follow-up showed no recurrence at present.

Key words: Endometrial neoplasms, Adenomyosis, Therapy, Prognosis, Case reports

李霞, 刘世凯. 子宫内膜癌合并子宫腺肌病癌变一例及文献复习[J]. 国际妇产科学杂志, 2022, 49(6): 640-643.

LI Xia, LIU Shi-kai. Endometrial Carcinoma with Adenomyosis Malignant Transformation: A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2022, 49(6): 640-643.

图/表 4

图1 盆腔MRI图注：A 子宫内膜病变累及浅肌层，B 子宫腺肌病病灶。

图2 术中探查情况注：子宫体形态饱满，右侧输卵管积水。

图3 术后病理图（HE染色×100）注：A 子宫内膜癌浅肌层浸润，B 子宫腺肌病癌变病灶。

图4 免疫组织化学检查图（×100）注：A ER阳性；B PR阳性。

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