PDF(Pubmed)
Abstract：
Extrauterine endometrial stromal sarcoma arising from malignant transformation of the vagina is an extremely rare condition. The diagnosis is often difficult as the symptomatology and pathological features overlap with that of pelvic endometriosis. A 38 years old female presented with complaints of dyspareunia, dysmenorrhea, and painful defecation along with blood-stained vaginal discharge for a year. Examination revealed the presence of multiple brownish irregular nodules in posterior vaginal fornix and fixed tender nodules which on biopsy revealed florid vaginal endometriosis. She improved symptomatically on medical therapy. After 18 months of diagnosis, she presented again with a necrotic growth in posterior fornix, which on repeat biopsy revealed a low-grade endometrial stromal sarcoma. Laparotomy revealed a 7×5 cm mass in the pouch of Douglas, infiltrating the posterior vaginal wall and rectum. A complete cytoreductive surgery with retrograde hysterectomy, excision of posterior vaginal wall and rectosigmoid resection was done. The patient is disease-free at a follow-up of 65 months.
摘要：
由阴道恶性转化引起的子宫外子宫内膜间质肉瘤是一种极为罕见的疾病。诊断通常很困难，因为症状和病理特征与盆腔子宫内膜异位症重叠。一名38岁女性出现性交困难的投诉，痛经,痛苦的排便和血染的阴道分泌物持续了一年。检查发现在阴道后穹窿中存在多个褐色不规则结节，并在活检中发现了静脉状阴道子宫内膜异位症。她在药物治疗后症状好转。经过18个月的诊断，她再次出现后穹窿坏死，重复活检显示低度子宫内膜间质肉瘤。剖腹手术显示道格拉斯囊袋有7×5厘米的肿块，浸润阴道后壁和直肠。完整的细胞减灭术与逆行子宫切除术，行阴道后壁切除术和直肠乙状结肠切除术。患者在65个月的随访中无疾病。
