PDF(Pubmed)
Abstract：
BACKGROUND: Endometrial stromal tumors originate from the endometrial stroma and account for < 2% of all uterine tumors. Uterine tumor resembling an ovarian sex cord tumor (UTROSCT) is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors. Here, we report a case of UTROSCT in a 51-year-old woman.
METHODS: A 51-year-old woman had irregular menses for 6 mo. The patient visited a local hospital for vaginal bleeding. Pelvic computed tomography (CT) showed a mass in the pelvic cavity. Five days later, she came to our hospital for further diagnosis. The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor. She then underwent total removal of the uterus with bilateral salpingectomy. Postoperative histological examination showed that the tumor cells had abundant cytoplasm, ovoid and spindle-shaped nuclei, fine chromatin, a high nucleoplasm ratio, and a lamellar distribution. The findings were consistent with UTROSCT, and the results of immunohistochemical analysis supported that diagnosis. The tumor was International Federation of Gynecology and Obstetrics stage IB. No adjuvant therapy was administered after radical surgery. The patient was followed up for 58 mo, and no recurrence was found.
CONCLUSIONS: We report a case of UTROSCT with abnormal menstruation as a symptom, which is one of the most common symptoms. In patients with vaginal bleeding, ultrasonography can be used as a screening test because of its convenience, speed, and lack of radiation exposure. For patients with long-term tamoxifen use, routine monitoring of the endometrium is recommended. As UTROSCT may have low malignant potential, surgery remains the primary management strategy. Additionally, fertility preservation in patients of childbearing age is a vital consideration.
METHODS: A 51-year-old woman had irregular menses for 6 mo. The patient visited a local hospital for vaginal bleeding. Pelvic computed tomography (CT) showed a mass in the pelvic cavity. Five days later, she came to our hospital for further diagnosis. The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor. She then underwent total removal of the uterus with bilateral salpingectomy. Postoperative histological examination showed that the tumor cells had abundant cytoplasm, ovoid and spindle-shaped nuclei, fine chromatin, a high nucleoplasm ratio, and a lamellar distribution. The findings were consistent with UTROSCT, and the results of immunohistochemical analysis supported that diagnosis. The tumor was International Federation of Gynecology and Obstetrics stage IB. No adjuvant therapy was administered after radical surgery. The patient was followed up for 58 mo, and no recurrence was found.
CONCLUSIONS: We report a case of UTROSCT with abnormal menstruation as a symptom, which is one of the most common symptoms. In patients with vaginal bleeding, ultrasonography can be used as a screening test because of its convenience, speed, and lack of radiation exposure. For patients with long-term tamoxifen use, routine monitoring of the endometrium is recommended. As UTROSCT may have low malignant potential, surgery remains the primary management strategy. Additionally, fertility preservation in patients of childbearing age is a vital consideration.
摘要：
背景：子宫内膜间质瘤起源于子宫内膜间质，占所有子宫肿瘤的<2%。根据世界卫生组织最新的女性生殖器肿瘤分类，类似于卵巢性索肿瘤（UTROSCT）的子宫肿瘤是一种罕见的子宫内膜间质及相关肿瘤。这里,我们报告一例51岁女性的UTROSCT。
方法：一名51岁女性月经不调6个月。患者因阴道出血到当地医院就诊。盆腔计算机断层扫描（CT）显示盆腔中有肿块。五天后,她来我们医院做进一步的诊断。我院CT造影及盆腔超声检查结果提示盆腔恶性肿瘤。然后，她通过双侧输卵管切除术完全切除子宫。术后组织学检查显示肿瘤细胞具有丰富的细胞质，卵形和纺锤形核，细染色质，高的核质比，和层状分布。研究结果与UTROSCT一致，免疫组织化学分析的结果支持了这一诊断。肿瘤为国际妇产科联合会IB期。根治性手术后未给予辅助治疗。病人接受了58个月的随访,没有发现复发。
结论：我们报告一例以月经异常为症状的UTROSCT，这是最常见的症状之一。在阴道出血的患者中，超声检查由于其便利性可以用作筛查测试，速度,缺乏辐射暴露。对于长期使用他莫昔芬的患者，建议对子宫内膜进行常规监测.由于UTROSCT可能具有低恶性潜能，手术仍然是主要的管理策略。此外,育龄患者的生育能力保护是一个重要的考虑因素。
方法：一名51岁女性月经不调6个月。患者因阴道出血到当地医院就诊。盆腔计算机断层扫描（CT）显示盆腔中有肿块。五天后,她来我们医院做进一步的诊断。我院CT造影及盆腔超声检查结果提示盆腔恶性肿瘤。然后，她通过双侧输卵管切除术完全切除子宫。术后组织学检查显示肿瘤细胞具有丰富的细胞质，卵形和纺锤形核，细染色质，高的核质比，和层状分布。研究结果与UTROSCT一致，免疫组织化学分析的结果支持了这一诊断。肿瘤为国际妇产科联合会IB期。根治性手术后未给予辅助治疗。病人接受了58个月的随访,没有发现复发。
结论：我们报告一例以月经异常为症状的UTROSCT，这是最常见的症状之一。在阴道出血的患者中，超声检查由于其便利性可以用作筛查测试，速度,缺乏辐射暴露。对于长期使用他莫昔芬的患者，建议对子宫内膜进行常规监测.由于UTROSCT可能具有低恶性潜能，手术仍然是主要的管理策略。此外,育龄患者的生育能力保护是一个重要的考虑因素。
