阴道直肠隔子宫内膜样腺癌1例  

Endometrioid adenocarcinoma of the rectovaginal septum:A case report

作　　者：慕庆玲 王纯[1] 刘红云[2] 许友征 栾少红[1] 夏宝国[1] MU Qingling;WANG Chun;LIU Hongyun;XU Youzheng;LUAN Shaohong;XIA Baoguo(Department of Gynecology,Qingdao Municipal Hospital(Group),Qingdao Shandong 266000;Department of Pathology,Qingdao Municipal Hospital(Group),Qingdao Shandong 266000,China)

机构地区：[1]青岛市市立医院(集团)妇科,山东青岛266000 [2]青岛市市立医院(集团)病理诊断中心,山东青岛266000

出　　处：《中南大学学报（医学版）》2023年第6期941-946,共6页Journal of Central South University ：Medical Science

摘　　要：原发性阴道直肠隔子宫内膜样腺癌罕见,发病机制尚不明确,临床无标准治疗方案。青岛市市立医院收治1例起源于深部浸润型子宫内膜异位症的阴道直肠隔子宫内膜样腺癌患者,因“月经淋漓不尽伴腹胀1个月、发现盆腔包块3天”就诊,既往曾于6年前行腹腔镜下双侧卵巢子宫内膜异位囊肿剥除术。影像学检查提示盆腔肿块可能侵及阴道直肠隔。初次保守手术病理证实阴道直肠隔子宫内膜样腺癌。其后行全面分期手术,术后化学治疗6次,随访2年无疾病复发及转移。临床遇到有子宫内膜异位症病史的患者,影像学发现卵巢外的盆腔病变时,应考虑到深部浸润型子宫内膜异位症及发生恶变的可能性,避免漏诊和误诊。Primary endometrioid adenocarcinoma of the rectovaginal septum is rare.Its pathogenesis is not clear and there is no standard treatment.One patient with endometrioid adenocarcinoma of the rectovaginal septum arising from deep infiltrative endometriosis was admitted to Qingdao Municipal Hospital.The patient presented with incessant menstruation and abdominal distension.She had bilateral ovarian endometriotic cystectomy 6 years ago.Imaging findings suggested a pelvic mass which might invade the rectovaginal septum.Pathological results of primary surgery confirmed endometrioid carcinoma of the pelvic mass arising from the rectovaginal septum.Then she had a comprehensive staged surgery.Postoperative chemotherapy was given 6 times.No recurrence or metastasis was found during the 2-year follow-up.The possibility of deep infiltrating endometriosis and its malignant transformation should be considered in the differential diagnosis of a new extragonadal pelvic lesion in a patient with a history of endometriosis,which would avoid misdiagnosis and missed diagnosis.

关 键 词：子宫内膜样腺癌 子宫内膜异位症 深部浸润型子宫内膜异位症 阴道直肠隔 

分 类 号：R737.33[医药卫生—肿瘤]