目的 探讨子宫苗勒管腺肉瘤伴肉瘤过度生长（Müllerian adenosarcoma of the uterus with sarcomatous overgrowth，MASO）的临床病理特征、生物学行为及预后。方法 对3例MASO采用光镜、免疫组化染色观察，并复习相关文献。结果 3...目的 探讨子宫苗勒管腺肉瘤伴肉瘤过度生长（Müllerian adenosarcoma of the uterus with sarcomatous overgrowth，MASO）的临床病理特征、生物学行为及预后。方法 对3例MASO采用光镜、免疫组化染色观察，并复习相关文献。结果 3例患者分别表现为不规则阴道出血、绝经后阴道出血及子宫增大。大体上，宫腔内见息肉状肿物，直径2～13cm，2例浸润浅肌层，1例浸润深肌层达浆膜。组织学上，3例MASO均见典型腺肉瘤结构，即由良性腺体和低度恶性肉瘤样成分混合而成，其中纯粹肉瘤成分比例均超过25％，并且肉瘤级别比相邻的腺肉瘤高；例2含有异源成分。3例肉瘤成分均显示vimentin阳性，而EMA、CD10、desmin、SMA、S-100蛋白等均阴性。3例均行全子宫＋双侧附件切除术，1例进行了盆腔淋巴结清扫。2例术后分别随访3年及5年均无瘤生存，1例术后1个月死亡。结论 MASO是一种少见的Müllerian混合上皮和间质肿瘤，具有独特的临床病理形态特征；与经典的子宫Müllerian腺肉瘤相比，它更具有侵袭性，预后差。展开更多
Background. Uterine Mullerian adenosarcoma (UMA) is a rare and low- grade variant of mixed mesodermal tumor. UMA recurrences including heterologous sarcomatous elements are extremely rare, with only 3 cases reported t...Background. Uterine Mullerian adenosarcoma (UMA) is a rare and low- grade variant of mixed mesodermal tumor. UMA recurrences including heterologous sarcomatous elements are extremely rare, with only 3 cases reported thus far. Case. We present a case of UMA recurring as heterologous sarcoma three times in 8 months for 9.4 years after primary treatment. The number and grade of sarcomatous components increased with each recurrence eventually resulting in loss of the patient. Conclusion. The presence of multiple sarcomatous elements of high histological grade in the recurrent tumor following UMA may indicate an unfavorable prognosis with common recurrences and fatal outcome. All UMA patients carry risk of late recurrence, therefore, they should receive long- term follow- up.展开更多
文摘目的 探讨子宫苗勒管腺肉瘤伴肉瘤过度生长（Müllerian adenosarcoma of the uterus with sarcomatous overgrowth，MASO）的临床病理特征、生物学行为及预后。方法 对3例MASO采用光镜、免疫组化染色观察，并复习相关文献。结果 3例患者分别表现为不规则阴道出血、绝经后阴道出血及子宫增大。大体上，宫腔内见息肉状肿物，直径2～13cm，2例浸润浅肌层，1例浸润深肌层达浆膜。组织学上，3例MASO均见典型腺肉瘤结构，即由良性腺体和低度恶性肉瘤样成分混合而成，其中纯粹肉瘤成分比例均超过25％，并且肉瘤级别比相邻的腺肉瘤高；例2含有异源成分。3例肉瘤成分均显示vimentin阳性，而EMA、CD10、desmin、SMA、S-100蛋白等均阴性。3例均行全子宫＋双侧附件切除术，1例进行了盆腔淋巴结清扫。2例术后分别随访3年及5年均无瘤生存，1例术后1个月死亡。结论 MASO是一种少见的Müllerian混合上皮和间质肿瘤，具有独特的临床病理形态特征；与经典的子宫Müllerian腺肉瘤相比，它更具有侵袭性，预后差。
文摘Background. Uterine Mullerian adenosarcoma (UMA) is a rare and low- grade variant of mixed mesodermal tumor. UMA recurrences including heterologous sarcomatous elements are extremely rare, with only 3 cases reported thus far. Case. We present a case of UMA recurring as heterologous sarcoma three times in 8 months for 9.4 years after primary treatment. The number and grade of sarcomatous components increased with each recurrence eventually resulting in loss of the patient. Conclusion. The presence of multiple sarcomatous elements of high histological grade in the recurrent tumor following UMA may indicate an unfavorable prognosis with common recurrences and fatal outcome. All UMA patients carry risk of late recurrence, therefore, they should receive long- term follow- up.
