子宫内膜血管肉瘤临床误诊分析  

Clinical Misdiagnosis of Endometrial Angiosarcoma

作　　者：冼建文 张婷 谢伟丽 XIAN Jianwen;ZHANG Ting;XIE Weili(Department of Obstetrics and Gynecology,Xiaolan People's Hospital of Zhongshan City,Zhongshan,Guangdong 528415,China)

机构地区：[1]中山市小榄人民医院妇产科,广东中山528415

出　　处：《临床误诊误治》2025年第1期3-6,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨子宫内膜血管肉瘤的临床误诊原因。方法分析2012年4月至2023年5月收治6例曾误诊的子宫内膜血管肉瘤患者的临床资料。结果本组6例中有3例以阴道不规则流血为主要症状,1例以月经量增多且经期延长为主要症状,2例以无诱因阴道流血且多于月经量,伴少量黄色分泌物为主要症状。6例行影像学及分段诊断性刮宫检查均误诊为子宫内膜癌,误诊时间4~8(5.34±0.96)周。6例经术后病理及免疫组化检查最终确诊为子宫内膜血管肉瘤,其中Ⅱ期1例,Ⅲ期5例。随访12个月,1例无复发及转移,5例复发,其中3例远处转移。结论子宫内膜血管肉瘤应与其他子宫恶性肿瘤相鉴别,并对患者进行综合分析,依据病理及免疫组化结果确诊。Objective To explore the causes of clinical misdiagnosis of endometrial angiosarcoma.Methods The clinical data of 6 patients with misdiagnosed endometrial angiosarcoma admitted to our hospital from April 2012 to May 2023 were analyzed.Results Among the 6 patients in this group,3 patients had irregular vaginal bleeding as the main symptom,1 patient had increased menstrual volume and prolonged menstrual period as the main symptom,and 2 patients had unexplained vaginal bleeding exceeding menstrual flow and a small amount of yellow discharge as the main symptom.All 6 patients were misdiagnosed as endometrial cancer by imaging and segmental diagnostic curettage,and the misdiagnosis time lasted 4-8(5.34±0.96)weeks.Six patients were finally diagnosed as endometrial angiosarcoma by postoperative pathological and immunohistochemical examination,including 1 case of stageⅡand 5 cases of stageⅢ.After 12 months of follow-up,1 patient had no recurrence and metastasis,5 patients had recurrence,3 of whom had distant metastasis.Conclusion Endometrial angiosarcoma should be distinguished from other uterine malignancies,and the patients should be comprehensively analyzed and confirmed according to pathological and immunohistochemical results.

关 键 词：子宫内膜肿瘤 血管肉瘤 误诊 子宫内膜癌 诊断性刮宫 

分 类 号：R737.33[医药卫生—肿瘤]