妊娠治疗期间成功妊娠及保留生育能力的优势:1例报告。

Selçuk Ayas, Lutfiye Uygur, Evrim Bostanci, Ayşe Gürbüz
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引用次数: 0

摘要

背景:宫颈腺样肉瘤是一种罕见的女性生殖道横纹肌肉瘤(RMS)。它通常在生命的第一个或第二个十年被诊断出来。在这个病例报告中,我们的目的是介绍一个21岁的无孕患者,他被诊断为宫颈胚胎性RMS,讨论文献中提到的治疗方案,并强调在这些年轻患者中保留生育能力的优势。病例:我们报告一名21岁无阴道的女性,在镜检查中表现为8×7厘米的“葡萄状”宫颈息肉。活检组织病理学检查结合免疫组织化学染色,用desmin, myogenin, S100, vimentin和myhemoglobin。随访期间采用阴道镜检查、二次活检和正电子发射断层扫描。组织病理学检查显示子宫颈胚胎性RMS。她接受了三个周期的联合化疗,阿霉素和异环磷酰胺。她拒绝接受手术,因为化疗后两个月她意外怀孕了。她在随访期间迷路了。在顺利怀孕并成功分娩后,她在产后第6个月再次申请。阴道镜检查显示局部息肉区,活检组织病理检查提示复发,即使正电子发射断层扫描不明显。因此,补充治疗计划为锥形和盆腔淋巴结切除术。组织病理学检查显示锥形材料上未见肿瘤残留,盆腔淋巴结未受累。结论:保留生育能力,在化疗阶段采用多柔比星联合异环磷酰胺是一种可行的管理方案。在治疗期间怀孕和成功分娩是可能的。阴道镜检查对早期发现复发具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A successful pregnancy during the treatment of cervical sarcoma botryoides and advantage of fertility sparing management: A case report.

A successful pregnancy during the treatment of cervical sarcoma botryoides and advantage of fertility sparing management: A case report.

Background: Sarcoma botryoides of cervix is a rare variant of rhabdomyosarcomas (RMS) of female genital tract. It is usually diagnosed in first or second decade of life. In this case report, we aimed to present a 21 year-old nulligravid patient who was diagnosed with embryonal RMS of the cervix, to discuss the treatment options that have been stated in the literature, and to highlight the advantage of fertility sparing management in these young patients.

Case: We report a 21-year-old nulligravid woman complaining about a mass protruding from introitus, which was represented with a 8×7 cm "grape-like" cervical polyp on speculum examination. The histopathologic examination of the biopsy taken was combined with immunohistochemical staining with desmin, myogenin, S100, vimentin, and myoglobin. Colposcopy, second biopsy, and positron emission tomography were used during the follow-up. The histopathologic examination revealed embryonal RMS of cervix. She received three cycles of combination chemotherapy, doxorubicin and ifosfamide. She refused to have a surgery because of an unplanned, desired pregnancy at two months after the chemotherapy. She was lost during the follow-up. After having an uneventful pregnancy and a successful delivery, she reapplied at postpartum 6(th) month. Colposcopic evaluation revealed a local polypoid area, the histopathologic examination of biopsy suggested recurrence even though positron emission tomography scans were unremarkable. Therefore complementary treatment was planned as conization and pelvic lymphadenectomy. The histopathology revealed no residual tumor on the conization material and no involvement of pelvic lymph nodes.

Conclusion: Fertility sparing management, including doxorubicin and ifosfamid combination in chemotherapy step, can be management option. Pregnancy and successful delivery is possible during the treatment. Colposcopy has importance for early detection of recurrences.

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