诊断和治疗浆液性囊腺纤维瘤样肿瘤可能引起尿路子宫内膜异位症：1例报告

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2025-03-01 DOI:10.1016/j.tjog.2024.12.014

Yu Horibe, Ruriko Takase, Toshiyuki Kanno, Akira Nakabayashi, Jun Kumakiri, Tsutomu Tabata

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引用次数: 0

摘要

目的尿路子宫内膜异位症占子宫内膜异位症的0.3% ~ 12%。药物治疗晚期疾病的疗效有限。浆液性囊腺纤维瘤是一种罕见的卵巢上皮性肿瘤的良性变异，包括上皮和纤维间质成分。由于其视觉上与恶性肿瘤相似，其诊断具有挑战性。一例诊断为输尿管子宫内膜异位症的患者接受了右肾和输尿管的手术切除。十年后，患者在同一部位出现疑似恶性肿瘤。经剖腹探查，病理诊断为浆液性囊腺纤维瘤。结论仅凭影像学表现将此类肿瘤与其他恶性肿瘤鉴别是具有挑战性的。术中宏观检查和快速病理评估是判断手术干预程度的关键。促性腺激素释放激素类似物（GnRHa）和dienogest （DNG）治疗在预防子宫内膜异位症手术后此类肿瘤复发的疗效仍不确定。

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Diagnosis and treatment of a serous cystadenofibroma-like tumor potentially arising from urinary tract endometriosis: A case report

Objective

Urinary tract endometriosis affects 0.3–12 % of all cases of endometriosis. Medications have limited efficacy in treating advanced disease. Serous cystadenofibroma is a rare benign variant of ovarian epithelial tumors comprising both epithelial and fibrous stromal components. Its diagnosis is challenging due to its visual resemblance to malignancy.

Case report

A patient diagnosed with ureteral endometriosis underwent surgical excision of the right kidney and ureter. Ten years later, the patient developed a tumor suspected to be malignant at the same site. Following exploratory laparotomy, the tumor was pathologically diagnosed as resembling serous cystadenofibroma.

Conclusion

Differentiating a such tumors from other malignancies based solely on imaging findings is challenging. It is crucial to judge the degree of surgical intervention through intraoperative macroscopic examination and rapid pathological assessment. The efficacy of gonadotropin-releasing hormone analog (GnRHa) and dienogest (DNG) therapy in preventing the recurrence of such tumors following surgery for endometriosis remains uncertain.

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.