摘要
报告1例绝经后妇女原发于子宫内膜的卵黄囊瘤病例。该患者为57岁女性,主要临床表现为绝经后阴道出血,伴有血清肿瘤标志物甲胎蛋白(alpha-fetoprotein,AFP)升高,妇科超声提示子宫内膜增厚并回声不均,可见较丰富血流,右侧宫腔占位病变;盆腔磁共振成像示子宫肌层及宫腔内异常信号影。该患者于2024年1月2日行经腹全子宫切除+双侧附件切除+盆腔及腹主动脉旁淋巴结清扫+大网膜切除术,术后病理提示子宫内膜卵黄囊瘤。截至2024年5月,患者已完成6次化疗,一般情况良好,未发现复发及转移。绝经后妇女原发性子宫内膜卵黄囊瘤恶性程度高、预后差,临床表现无特异性,确诊主要依靠病理学检查和免疫组织化学检查,早发现、早诊断并制定个体化的治疗方案是改善患者预后的关键。
One case of yolk sac tumor with primary endometrium in a postmenopausal woman was reported.The patient was a 57-year-old woman with postmenopausal vaginal bleeding,accompanied by the elevated level of serum tumor marker alpha-feto protein(AFP).Gynecological ultrasound showed the thickening endometrium and uneven echo,abundant blood flow,and a right uterine cavity mass lesion.Pelvic magnetic resonance imaging showed the abnormal signal shadows in the myometrium and intrauterine cavity.On January 2,2024,the patient underwent transabdominal total hysterectomy+double salpingectomy+pelvic and abdominal para-aortic lymph node dissection+omentectomy,and the postoperative pathological results suggested endometrial yolk sac tumor.As of May 2024,the patient has undergone 6 rounds of chemotherapy and is generally in good condition,with no recurrence or metastasis.The primary endometrial yolk sac tumor in postmenopausal women is highly malignant,with poor prognosis and the non-specific clinical manifestations.The diagnosis mainly depends on pathological examination and immunohistochemical examination.The early detection,early diagnosis and individualized treatment plan are the key factors to improve the prognosis of patients.
作者
史红丽
许莉欣
廉红梅
SHI Hong-li;XU Li-xin;LIAN Hong-mei(Medical Department,School of Medicine,Wuhan University of Science and Technology,Wuhan 430081,China;Department of Gynecology,Hubei Provincial Maternal and Child Health Hospital,Wuhan 430081,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2024年第6期479-484,共6页
Journal of International Reproductive Health/Family Planning
关键词
绝经后期
内胚层窦瘤
甲胎蛋白类
免疫组织化学
肿瘤辅助疗法
Postmenopause
Endodermal sinus tumor
Alpha-fetoproteins
Immunohistochemistry
Neoadjuvant therapy
