子宫内膜癌是高收入国家中最常见的恶性生殖道肿瘤,是仅次于宫颈癌的全球第二常见癌症。子宫内膜异位症是一种良性病症,其中在子宫腔外发现子宫内膜腺体和基质。
在对一名64岁女性的子宫和附件进行常规护理和超声检查期间,子宫内膜厚度增加(22mm).根据超声报告,2023年,患者接受了免疫组织化学诊断性刮宫术,揭示了子宫内膜癌(子宫内膜样腺癌)的病理诊断,p16,雌激素受体(ER)染色阳性,还有波形蛋白.随后,一周后,她接受了完整的手术分期。在手术和术前检查期间,注意到广泛的浅表子宫内膜异位症在骨盆和外阴中扩散。最终病理证实为高分化的典型子宫内膜样癌(1级),肌层浸润40%,淋巴血管浸润阳性。患者被认为处于1A阶段。
尽管一些研究表明子宫内膜异位症与子宫内膜样或透明细胞卵巢癌之间存在不明确的关联,子宫内膜异位症与子宫内膜癌及其预后之间的相关性仍不明确。此外,尽管在各种研究中不孕症与子宫内膜癌和子宫内膜异位症有关,该病例没有出现不孕症的迹象。存在广泛的盆腔子宫内膜异位症伴外阴受累,然而,患者没有出现任何症状。这与子宫内膜癌的典型初始表现相反,这是异常子宫出血。由于子宫内膜厚度异常增加,通过常规护理偶然发现患者的病情,提示这个演示。
UNASSIGNED: Endometrial cancer represents the most prevalent malignant genital tract neoplasm in high-income countries and is the second most common cancer worldwide following cervical cancer. Endometriosis is a benign condition wherein endometrial glands and stroma are found outside the uterine cavity.
UNASSIGNED: During a routine care and ultrasound examination of the uterus and adnexa of a 64-year-old woman, an increased endometrial thickness (22 mm) was noted. In 2023, according to ultrasound report, the patient underwent diagnostic curettage with immunohistochemistry, revealing a pathological diagnosis of endometrial cancer (endometrioid adenocarcinoma) with positive staining for p16, estrogen receptor (ER), and vimentin. Subsequently, after one week, she underwent complete surgical staging. Extensive superficial endometriosis disseminated in the pelvis and
vulva was noted during surgery and preoperative examinations. Final pathology confirmed a well-differentiated typical endometrioid carcinoma (grade 1) with 40% myometrial invasion and positive lymphovascular invasion. The patient was considered to be at stage 1A.
UNASSIGNED: Despite some studies suggesting an unclear association between endometriosis and endometrioid or clear-cell ovarian cancers, the correlation between endometriosis and endometrial cancer and its prognosis remains ambiguous. Additionally, although infertility has been linked to both endometrial cancer and endometriosis in various studies, the presented case exhibited no signs of infertility. Extensive pelvic endometriosis with vulvar involvement was present, yet the patient did not exhibit any symptoms. This is in contrast to the typical initial manifestation of endometrial cancer, which is abnormal uterine bleeding. The patient\'s condition was incidentally detected through routine care due to an abnormal increase in endometrial thickness, prompting this presentation.