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目的探讨子宫腺肌病癌变并双侧卵巢转移病例的临床病理特点。方法分析1例子宫腺肌病癌变并双侧卵巢转移的组织学及免疫组化染色,并进行相关文献复习。结果患者女性,44岁。因子宫肌瘤5年,下腹痛20余天入院。手术切除全子宫及双侧附件。巨检发现子宫肌层弥漫增厚并见多处灰黄色烂肉样组织溢出,子宫内膜较光滑,局部呈息肉样。双侧卵巢均见灰白色肿物,与卵巢组织界限不清。大网膜见多处灰白色结节。镜下子宫肌层见异位的子宫内膜腺体及间质,多处子宫内膜腺体呈重度不典型性并浸润性生长,双侧卵巢均见多处癌灶,为子宫内膜样腺癌。输卵管外膜及大网膜均查见转移癌。结论本例子宫腺肌病和卵巢均发现子宫内膜样腺癌,但卵巢癌灶的生长分布不符合卵巢原发性子宫内膜样腺癌的特点,考虑卵巢的子宫内膜样腺癌灶来自子宫的转移。
Objective To investigate the clinicopathological features of adenocarcinoma with bilateral ovarian metastasis. Methods The histological and immunohistochemical staining of 1 case of adenomyosis and bilateral ovarian metastasis was analyzed and related literatures were reviewed. Results Female patient, 44 years old. 5 years due to uterine fibroids, abdominal pain more than 20 days admitted. Surgical removal of the entire uterus and bilateral attachment. Found that the myometrium giant myometrial diffuse thickening and see a lot of gray-yellow rotten tissue overflow, the endometrium is more smooth, the local polypoid. Bilateral ovarian tumors were seen gray, unclear boundaries with the ovarian tissue. Omental see many gray nodules. Endoscopic myomectomy to see the ectopic endometrial glands and stroma, multiple endometrial glands was severe atypical and infiltrative growth, multiple ovarian tumors were seen, as the endometrioid Adenocarcinoma Fallopian tube and omentum were found metastatic carcinoma. Conclusion This case of adenomyosis and ovarian endometrial adenocarcinoma are found, but the growth distribution of ovarian foci does not meet the characteristics of ovarian primary endometrial adenocarcinoma, consider ovarian endometrioid adenocarcinoma Transfer from the uterus.