背景:阴道中肾腺癌(MA)是一种罕见的肿瘤,起源于女性生殖道中肾残留物(Wolffian)。这是一种肿瘤,没有关于其诊断的重要证据,治疗,随访和预后。
方法:在Scopus进行了文献的系统研究,PubMed/MEDLINE,ScienceDirect和Cochrane图书馆,包括观察性前瞻性和回顾性研究,病例系列和病例报告。我们收集了与诊断和治疗方案相关的研究数据,评估了以下方面:研究设计,人口,治疗类型,手术并发症发生率和生育结局。我们进一步纳入了一例腹腔镜治疗MA的病例报告。
结果:文献中有13例阴道MA,包括我们的病例报告.诊断时的中位年龄为52岁;大多数患者报告阴道出血为症状(38%);超声检查,其次是磁共振和CT扫描是最常用的诊断工具.在54%的案例中,进行了手术活检,92%的患者接受了开放入路或阴道切除术的前期手术,除了一例完全通过微创手术治疗。大多数患者(68%)接受了化疗或放疗或其组合的辅助治疗。平均随访期为6年。
结论:尽管这种癌症罕见且位置怪异,经过多学科评估,微创方法似乎是可行的。根据这种肿瘤的稀有性,任何未来的病例和后续数据都必须在文献中报告,以扩大相关知识。
BACKGROUND: Mesonephric adenocarcinoma (MA) of the vagina is a rare tumor that arises from mesonephric remnants (Wolffian) in the female genital tract. It is a neoplasm with no significant evidence about its diagnosis, treatment, follow-up and prognosis.
METHODS: Systematic research of the literature was conducted in Scopus, PubMed/MEDLINE, ScienceDirect and the Cochrane Library, including observational prospective and retrospective studies, case series and case reports. We collected data regarding studies related to diagnosis and treatment options evaluating the following aspects: study design, population, treatment type, rate of surgical complications and fertility outcome. We further included a case report of laparoscopic management of MA with pictorial assays.
RESULTS: Thirteen cases of MA of the vagina are available in the literature, including our case report. The median age at diagnosis was 52 years old; the majority of patients reported vaginal bleeding as a symptom (38%); and ultrasound, followed by a magnetic resonance and CT scan were the diagnostic tools most used. In 54% of the cases, a surgical biopsy was performed, and 92% of the patients underwent upfront surgery with an open access or vaginal resection except one case fully managed by minimally invasive surgery. Most of the patients (68%) received adjuvant treatment with chemotherapy or radiotherapy or a combination of them. The mean follow-up period was 6 years.
CONCLUSIONS: Despite the rarity of this cancer and bizarre location, a minimally invasive approach seems feasible after multidisciplinary evaluation. According to the rarity of this tumor, any future case and follow-up data must be reported in the literature in order to enlarge the knowledge about it.