腹腔鏡補助下腟式子宮全摘術後に子宮体癌と診断された一例

概要

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Laparoscopic surgery is increasingly recommended for the treatment of benign uterine pathologies. We report a case of endometrial cancer diagnosed after laparoscopically-assisted vaginal hysterectomy for uterine fibroids. The patient was 70 years-of-age, gravida 2, para 2. She was referred to our department for evaluation of a pelvic mass. Magnetic resonance imaging revealed numerous intramural leiomyomas ranging from 1 to 9 cm. Pap smears of endometrial scrapings showed no atypical cells. She was diagnosed with uterine fibroids preoperatively, and underwent laparoscopically-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy. The pathologic findings revealed serous adenocarcinoma of the uterine corpus without deep myometrial invasion. She received six courses of adjuvant chemotherapy with paclitaxel and carboplatin. There was no evidence of recurrent and metastatic tumor one year after the laparoscopic intervention. As use of laparoscopic hysterectomy increases, we need to be aware of the possibility of adenocarcinoma in elderly women with multiple leiomyomas, even when endometrial cytology is negative.
日本産科婦人科内視鏡学会の論文
2010-12-01