恶性潜能未定的子宫平滑肌瘤宫腔镜切除术后复发全子宫切除术一例

doi:10.12280/gjfckx.20240719

国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (1): 42-45.doi: 10.12280/gjfckx.20240719

• 妇科肿瘤研究:病例报告 • 上一篇下一篇

恶性潜能未定的子宫平滑肌瘤宫腔镜切除术后复发全子宫切除术一例

罗娜, 陈艳()

671000 云南省大理白族自治州妇幼保健院妇科

收稿日期:2024-08-11 出版日期:2025-02-15 发布日期:2025-02-14
通讯作者: 陈艳，E-mail：1330589012@qq.com
基金资助:
2024年度大理白族自治州妇幼保健院计划课题（自筹经费）(2024-zfy-08)

A Case of Recurrent Uterine Smooth Muscle Tumor of Uncertain Malignant Potential Underwent Hysterectomy after Hysteroscopic Lesion Resection

LUO Na, CHEN Yan()

Department of Gynecology, Dali Bai Autonomous Prefecture Maternal and Child Health Care Hospital, Dali Bai Autonomous Prefecture 671000, Yunnan Province, China

Received:2024-08-11 Published:2025-02-15 Online:2025-02-14
Contact: CHEN Yan, E-mail: 1330589012@qq.com

摘要/Abstract

摘要：

恶性潜能未定的子宫平滑肌瘤（uterine smooth muscle tumor of uncertain malignant potential，STUMP）是一类不能明确诊断为良、恶性的子宫平滑肌肿瘤，由于诊断较为复杂，目前诊断标准不统一，临床尚需更多的研究报道进行观察，为其诊断标准、治疗方式及预后情况提供更佳的循证医学证据。报告1例患者因宫腔占位病变行宫腔镜检查术，术中考虑0型子宫黏膜下肌瘤并予切净肌瘤，术后病理提示STUMP，术后2个月复发行全子宫切除术。回顾分析该病例提示，STUMP术前诊断不具有特异性，术后病理诊断复杂，术后可能短期内复发，强调定期、严密随访尤为重要。

关键词: 子宫肿瘤, 平滑肌瘤, 宫腔镜检查, 子宫肌瘤切除术, 肿瘤复发, 局部, 子宫切除术

Abstract:

Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is a kind of uterine smooth muscle tumor that can′t be clearly diagnosed as benign or malignant, dut to its the complexity of the diagnosis, the current diagnostic criteria are inconsistent, more clinical research reports are needed to provide better evidence-based medical evidence for its diagnosis, therapy and prognosis. We report a case of a patient who underwent hysteroscopy for a dominant lesion in the uterine cavity. Type 0 submucous fibroid was considered during the operation, and was resected. STUMP was diagnosed by pathology after the operation, and hysterectomy was performed 2 months after the operation. Retrospective analysis of this case suggests that the preoperative diagnosis of STUMP is not specific, postoperative pathological diagnosis is complicated, postoperative recurrence may occur in a short time after operation, emphasizing that regular and close follow-up is particularly important.

Key words: Uterine neoplasms, Leiomyoma, Hysteroscopy, Uterine myomectomy, Neoplasm recurrence, local, Hysterectomy

罗娜, 陈艳. 恶性潜能未定的子宫平滑肌瘤宫腔镜切除术后复发全子宫切除术一例[J]. 国际妇产科学杂志, 2025, 52(1): 42-45.

LUO Na, CHEN Yan. A Case of Recurrent Uterine Smooth Muscle Tumor of Uncertain Malignant Potential Underwent Hysterectomy after Hysteroscopic Lesion Resection[J]. Journal of International Obstetrics and Gynecology, 2025, 52(1): 42-45.

图/表 5

图1 2024年2月27日宫腔镜术中图像注：箭头所示为宫腔内黏膜下肌瘤样赘生物。

图2 2024年4月26日盆腔超声图注：箭头所示为实质低回声团及丰富血流信号。

图3 2024年4月29日术后全子宫剖视大体标本注：箭头所示为病灶。

图4 2024年5月3日术后病理图（HE染色）注：A 肿瘤呈多结节状生长，其内见不规则扩张的血管，×40，标尺=200 μm。B 局部肿瘤细胞增生稍密集，呈束状排列，×200，标尺=100 μm。C 肿瘤细胞呈梭形，胞界不清，见小核仁，散在分布核异型的肿瘤细胞，×400，标尺=50 μm。

图5 2024年5月3日IHC染色图（×400）注：A SMA（+），标尺=50 μm。B Desmin（+），标尺=50 μm。

参考文献 11

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恶性潜能未定的子宫平滑肌瘤宫腔镜切除术后复发全子宫切除术一例

A Case of Recurrent Uterine Smooth Muscle Tumor of Uncertain Malignant Potential Underwent Hysterectomy after Hysteroscopic Lesion Resection

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