乳头状子宫内膜腺癌伴宫颈发育不良1例报告及文献复习

M. Ramezani, Shadi Siami, S. Hosseini, M. Sadeghi
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摘要

目的:妇科恶性肿瘤多灶性是常见现象,但也可能出现同步肿瘤。同步癌约占妇科恶性肿瘤的1.7%。方法:以阴道出血为主诉的57岁女性住院。行子宫内膜刮除及宫颈活检。结果:病理报告:与乳头状腺癌相容,子宫内膜标本为II级,宫颈内膜标本为中等发育不良的鳞状上皮,宫颈内膜标本中有微小的非典型腺上皮碎片。病人拒绝手术切除病变,坚持用传统草药治疗。后来做了巴氏涂片检查,病理学家报告:“高度鳞状上皮内病变(HSIL)和非典型腺细胞,在萎缩背景下倾向于肿瘤”。结论:在妇科肿瘤病例中,要注意它可能伴随其他妇科恶性或癌前病变。第二种病变可能发生同步或异时性,也可能发生转移。许多同步恶性肿瘤的分期较低,预后比转移性病变好。彻底的抽样和检查对正确诊断和治疗至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Papillary Endometrial Adenocarcinoma with Cervical Dysplasia: Report of a Case and Review of Literature
Objective: Multifocality in gynecologic malignancies is a common phenomenon, however synchronous tumors may occur. Synchronous cancers are about 1.7% of gynecologic malignancies. Methods: A 57-year old female with chief complaint of vaginal bleeding was admitted. Endometrial curettage and cervical biopsy was done.Result: Pathologist reported: compatible with papillary adenocarcinoma, Grade II in endometrial sample and squamous epithelium with moderate dysplasia and tiny fragments of atypical glandular epithelium in endocervical samples. The patient refused for surgical excision of the lesion and insisted on to treat with conventional herbal medicine. Later Pap smear was done and pathologist reported: “High grade squamous intraepithelial lesion (HSIL) and atypical glandular cells, favor neoplastic in atrophic background”. Conclusion: In the case of gynecologic cancer be careful that it may accompany another gynecologic malignancy or premalignant lesion. The second lesion may occur synchronous or metachronous or may be metastatic. Many of the synchronous malignancies are presented in lower stages and have better prognosis than metastatic lesion. Thorough sampling and examination is important in correct diagnosis and treatment.
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