绝经后妇女原发性子宫内膜卵黄囊瘤一例  

A Case of Primary Endometrial Yolk Sac Tumor in A Postmenopausal Woman

作　　者：史红丽 许莉欣 廉红梅[2] SHI Hong-li;XU Li-xin;LIAN Hong-mei(Medical Department,School of Medicine,Wuhan University of Science and Technology,Wuhan 430081,China;Department of Gynecology,Hubei Provincial Maternal and Child Health Hospital,Wuhan 430081,China)

机构地区：[1]武汉科技大学医学部医学院,430081 [2]湖北省妇幼保健院妇科

出　　处：《国际生殖健康／计划生育杂志》2024年第6期479-484,共6页Journal of International Reproductive Health/Family Planning

摘　　要：报告1例绝经后妇女原发于子宫内膜的卵黄囊瘤病例。该患者为57岁女性,主要临床表现为绝经后阴道出血,伴有血清肿瘤标志物甲胎蛋白(alpha-fetoprotein,AFP)升高,妇科超声提示子宫内膜增厚并回声不均,可见较丰富血流,右侧宫腔占位病变;盆腔磁共振成像示子宫肌层及宫腔内异常信号影。该患者于2024年1月2日行经腹全子宫切除+双侧附件切除+盆腔及腹主动脉旁淋巴结清扫+大网膜切除术,术后病理提示子宫内膜卵黄囊瘤。截至2024年5月,患者已完成6次化疗,一般情况良好,未发现复发及转移。绝经后妇女原发性子宫内膜卵黄囊瘤恶性程度高、预后差,临床表现无特异性,确诊主要依靠病理学检查和免疫组织化学检查,早发现、早诊断并制定个体化的治疗方案是改善患者预后的关键。One case of yolk sac tumor with primary endometrium in a postmenopausal woman was reported.The patient was a 57-year-old woman with postmenopausal vaginal bleeding,accompanied by the elevated level of serum tumor marker alpha-feto protein(AFP).Gynecological ultrasound showed the thickening endometrium and uneven echo,abundant blood flow,and a right uterine cavity mass lesion.Pelvic magnetic resonance imaging showed the abnormal signal shadows in the myometrium and intrauterine cavity.On January 2,2024,the patient underwent transabdominal total hysterectomy+double salpingectomy+pelvic and abdominal para-aortic lymph node dissection+omentectomy,and the postoperative pathological results suggested endometrial yolk sac tumor.As of May 2024,the patient has undergone 6 rounds of chemotherapy and is generally in good condition,with no recurrence or metastasis.The primary endometrial yolk sac tumor in postmenopausal women is highly malignant,with poor prognosis and the non-specific clinical manifestations.The diagnosis mainly depends on pathological examination and immunohistochemical examination.The early detection,early diagnosis and individualized treatment plan are the key factors to improve the prognosis of patients.

关 键 词：绝经后期 内胚层窦瘤 甲胎蛋白类 免疫组织化学 肿瘤辅助疗法 

分 类 号：R737.33[医药卫生—肿瘤]