PDF(Pubmed)
Abstract：
Leiomyosarcomas of the uterine cervix are rare, mostly occurring in perimenopausal women. Diagnosis is based on pathology and immunohistochemistry. Surgery with a total abdominal hysterectomy and bilateral salpingo-oophorectomy remains the standard. A female patient in her 60s presented with heavy postmenopausal bleeding. Vaginal ultrasound scan and magnetic resonance imaging showed a large strongly vascularized cervical mass with features suspicious of sarcomatous degeneration. Positron Emission Tomography-Computed Tomography (PET-CT) did not reveal any evidence of metastases nor lymphadenopathy, but presence of right hydronephrosis. An abdominal hysterectomy with bilateral salpingo-oophorectomy, and end-to-end anastomosis of the right ureter, was performed. Pathology showed an International Federation of Gynecology and Obstetrics (FIGO)-stage 1B leiomyosarcoma of the uterine cervix. No adjuvant treatment was given. Adjuvant radiotherapy reduces the risk of recurrence but no survival impact. The benefit of adjuvant chemotherapy is questionable given the lack of randomized trials. Multidisciplinary research concerning molecular alterations of the disease is required to determine optimal management strategies with potential novel molecular therapies.
摘要：
宫颈平滑肌肉瘤很少见，多见于围绝经期妇女。诊断基于病理学和免疫组织化学。全腹子宫切除术和双侧附件卵巢切除术仍然是标准手术。一名60多岁的女性患者出现严重的绝经后出血。阴道超声扫描和磁共振成像显示一个大的强烈血管化的宫颈肿块，具有可疑的肉瘤变性的特征。正电子发射断层扫描-计算机断层扫描（PET-CT）未发现任何转移或淋巴结肿大的证据，而是右侧肾积水的存在.经腹子宫切除术伴双侧附件卵巢切除术，右输尿管端对端吻合,已执行。病理学显示国际妇产科联合会（FIGO）-宫颈平滑肌肉瘤1B期。未给予辅助治疗。辅助放疗可降低复发风险，但对生存无影响。由于缺乏随机试验，辅助化疗的益处值得怀疑。需要进行有关疾病分子改变的多学科研究，以确定具有潜在新型分子疗法的最佳管理策略。
