宫颈腺样囊性癌合并基底细胞癌及鳞状细胞癌一例  

A Case Report of Cervical Adenoid Cystic Carcinoma Combined with Basal Cell Carcinoma and Squamous Cell Carcinoma

作　　者：张纹 王雪倩 石玉香[3] 黄增发 田训[5] ZHANG Wen;WANG Xue-qian;SHI Yu-xiang;HUANG Zeng-fa;TIAN Xun(Department of Obstetrics and Gynecology,Postgraduate Training Base,Wuhan Central Hospital,Hubei University of Medicine,Wuhan 430014,China;Department of Obstetrics and Gynecology,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Pathology,Wuhan Central Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China;Department of Imaging,Wuhan Central Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China;Department of Obstetrics and Gynecology,Wuhan Central Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]湖北医药学院武汉市中心医院研究生培养基地妇产科,430014 [2]华中科技大学同济医学院附属同济医院妇产科 [3]华中科技大学同济医学院附属武汉中心医院病理科 [4]华中科技大学同济医学院附属武汉中心医院影像科 [5]华中科技大学同济医学院附属武汉中心医院妇产科

出　　处：《国际妇产科学杂志》2024年第3期258-262,266,共6页Journal of International Obstetrics and Gynecology

摘　　要：腺样囊性癌(adenoid cystic carcinoma,ACC)是一种来自涎腺组织的罕见恶性上皮肿瘤,发生于宫颈的ACC更为罕见,仅占所有宫颈腺癌的1%,其侵袭性强,预后较差,且尚未建立标准治疗方案。报告1例宫颈ACC合并基底细胞癌及鳞状细胞癌患者的诊治经过。患者为老年女性,因发现阴道口新生物伴阴道间断出血收治入院,阴道内新生物病理活检提示恶性肿瘤,符合ACC诊断,遂在腹腔镜下行盆腔淋巴结清扫术+广泛全子宫切除术+卵巢动静脉高位结扎术(双侧)+双侧卵巢和输卵管切除术+肠粘连松解术+肠系膜新生物切除术,术后病理提示宫颈混合癌,混合成分为ACC、腺样基底细胞癌及鳞状细胞癌,局部伴有非特异性梭形细胞肉瘤样间质,术后行2次化疗和1次放疗。患者术后恢复良好,随访至2024年1月22日规律复查未见转移及复发。Adenoid cystic carcinoma(ACC)is a rare malignant epithelial tumor originating from salivary gland tissue.The occurrence of ACC in the cervix is even rarer,representing for only 1% of all cervical adenocarcinomas.It is highly invasive,has a poor prognosis,and lacks a standard treatment plan.This article reports the diagnosis and treatment of a patient with cervical ACC combined with basal cell carcinoma and squamous cell carcinoma.The patient,an elderly woman,was admitted to the hospital for a newly discovered mass at the vaginal opening accompanied by intermittent vaginal bleeding.The pathological biopsy results of the vaginal mass showed malignant tumors,consistent with ACC;she underwent laparoscopic pelvic lymph node dissection+total hysterectomy+high ovarian arteriovenous ligation(bilateral)+bilateral ovarian and fallopian tube resection+intestinal adhesion lysis+mesenteric neoplasm resection.Postoperative pathology showed cervix mixed cancer composed of ACC,adenoid basal cell carcinoma and squamous cell carcinoma,along with local non-specific spindle cell sarcomatoid stroma.She received two cycles of chemotherapy and one session of radiotherapy postoperatively;the patient recovered well after surgery,and no metastasis or recurrence was found in regular follow-up examinations until January 22,2024.

关 键 词：宫颈肿瘤 诊断 治疗 预后 病例报告 

分 类 号：R737.33[医药卫生—肿瘤]