■输尿管芽的恶性肿瘤并不常见,宫颈受累更罕见。到目前为止,文献中没有这样的案例。
■一名50岁的女性在过去7个月中出现间歇性轻度出血,在过去2个月中出现下腹痛。人乳头瘤病毒16(HPV)DNA,P16化学染色,ThinThinPrep细胞学检查(TCT),宫颈及宫颈管组织活检均为阴性。盆腔彩色多普勒超声显示纵隔子宫不完整,宫颈管至宫颈后壁的回声不均匀。盆腔增强CT显示左侧颈部肿块,左侧腹膜后肿块,没有左肾,纵隔子宫.检测到人附睾蛋白4(HE4)(133.6pmol/L)的增加,而其他肿瘤标志物处于正常水平。根据这些检查结果,诊断为“宫颈肌瘤”,左侧腹膜后肿块,不完全纵隔子宫,进行了左肾虚[SIC],扩大子宫切除术,右侧附件切除术,行左侧腹膜后肿块切除术。通过术中快速病理诊断,术后病理诊断结合实验室重新评估,以及影像学和术中检查结果,患者被诊断为累及宫颈的输尿管芽肠型腺癌。患者已被追踪并随访了大约11个月。她接受了六个疗程的化疗。目前,已经停药4个月了,并且没有复发,转移,或肿瘤恶化。
■对于大量的子宫颈,进行操作是可行的,改善预后。有一些限制。未对肿块进行术前抽吸活检以区分良性和恶性。未进行术前尿路造影以阐明畸形泌尿系统结构的功能。对于肠型腺癌,应在切除输尿管芽的同时进行膀胱部分切除术。在这种情况下,未进行膀胱部分切除术,这只能通过术后化疗来补偿。此外,这个病人没有接受基因筛查,目前尚不清楚是否存在与输尿管芽肠腺癌相关的基因突变。
UNASSIGNED: Malignant tumors of the ureteric bud are not common, and cervical involvement is even rarer. So far, there have been no such cases in the literature.
UNASSIGNED: A 50-year-old woman developed intermittent light bleeding in the past 7 months and lower abdominal pain in the past 2 months. The human papillomavirus 16 (HPV) DNA, P16 chemical staining, thinPrep cytology test (TCT), and cervical and cervical canal tissue biopsy were all negative. Pelvic color Doppler ultrasound exhibited incomplete mediastinal uterus and heterogeneous echo from the cervical canal to the posterior wall of the cervix. Pelvic contrast-enhanced CT showed left cervical mass, left retroperitoneal mass, absence of the left kidney, and mediastinal uterus. An increase in human epididymal protein 4 (HE4) (133.6 pmol/L) was detected, while other tumor markers were at normal levels. Based on these examination results, a diagnosis of \"cervical fibroids, left retroperitoneal mass, incomplete mediastinal uterus, left kidney deficiency\"[SIC] was conducted, and expanded hysterectomy, right adnexectomy, and left retroperitoneal mass resection were performed. Through intraoperative rapid pathological diagnosis, postoperative pathological diagnosis combined with the re-evaluation of laboratory, and imaging and intraoperative examination results, the patient was diagnosed with ureteric bud intestinal-type adenocarcinoma involving the cervix. The patient has been tracked and followed up for approximately 11 months. She underwent six courses of chemotherapy. At present, the medication has been discontinued for 4 months, and there is no recurrence, metastasis, or deterioration of the tumor.
UNASSIGNED: For large masses of the cervix, it is feasible for the operation to be performed, improving the prognosis. There were a few limitations. A preoperative aspiration biopsy of masses was not performed to differentiate benign from malignant. Preoperative urography was not performed to clarify the function of the malformed urinary system structure. Partial cystectomy should be performed simultaneously with the resection of the ureteric bud for intestinal-type adenocarcinoma. In this case, a partial cystectomy was not performed, which can only be compensated with postoperative chemotherapy. Moreover, this patient did not undergo genetic screening, and it is currently unclear whether there are any genetic mutations associated with ureteric bud intestinal adenocarcinoma.