A case of atypical endometrial hyperplasia in early pregnancy and achieved a remission after delivery, but progressed to juvenile endometrial cancer 2 years later
| العنوان: | A case of atypical endometrial hyperplasia in early pregnancy and achieved a remission after delivery, but progressed to juvenile endometrial cancer 2 years later |
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| المصدر: | 静岡産科婦人科学会雑誌. 11(1):58-64 |
| بيانات النشر: | 静岡産科婦人科学会, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | endometrial cancer, laparoscopic total hysterectomy, cervical polyp, pregnancy, atypical endometrial hyperplasia |
| الوصف: | 子宮内膜異型増殖症合併妊娠は稀である。妊娠初期の子宮頸管ポリープの診断、切除により子宮内膜異型増殖症と診断され、分娩2年後に子宮体癌を発症した症例を経験したので報告する。症例は31歳、2妊1産。自然妊娠し、前医で妊娠12週に子宮頸管ポリープを切除した。病理検査で子宮内膜異型増殖症と診断され、妊娠16週に精査・妊娠管理目的で紹介された。妊娠を中断し、精査・加療することも検討したが、本人と家族の強い希望により妊娠継続の方針となった。妊娠経過に異常はなく、妊娠39週3日に2,506gの男児を正常経腟分娩した。産褥1か月時に2cm弱の子宮内腫瘤を認め、腫瘤摘出と内膜全面掻爬を行ったが、悪性所見はなく3か月毎の外来受診の方針とした。分娩2年後の頸部細胞診でAGCを指摘され、子宮内膜全面掻爬で類内膜癌の診断であった。MRI検査で筋層浸潤なく、CT検査で転移所見はなかった。挙児希望はなく、腹腔鏡下子宮全摘術と両側附属器切除術を施行した。病理診断は類内膜癌Grade1、pT1aで、子宮体癌ⅠA期と診断した。現在、経過観察中で再発を認めていない。子宮内膜異型増殖症合併妊娠は、分娩後に寛解しても慎重な経過観察が重要と考えられた。 Pregnancies complicated by endometrial atypical hyperplasia are rare. We report a case of atypical endometrial hyperplasia diagnosed by excision of cervical polyps in early pregnancy, and endometrial cancer developed 2 years after delivery. A 31-year-old, gravida 2, para 1 woman conceived spontaneously and had a cervical polyp removed at 12 weeks of gestation. The patient was diagnosed as atypical endometrial hyperplasia by pathological examination and was referred to our hospital at 16 weeks of gestation for further examination and maternal management during pregnancy. We considered termination of the pregnancy for further examination and treatment but decided to continue the pregnancy as it was according to the strong request of the patient and her family. The patient had a normal vaginal delivery of a 2,506g baby at 39 weeks. At one month after delivery, an intrauterine mass of less than 2cm was found. There were no malignant findings in the specimens obtained at the dilatation and curettage. We continued with follow-up observation. Two years after delivery, cervical cytology revealed AGC. The patient was diagnosed with endometrial carcinoma by endometrial biopsy. She did not wish to have a baby and underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. The pathological diagnosis was endometrioid carcinoma grade 1, pT1a. The patient is currently under follow-up and no recurrence has been observed. In conclusion, careful follow-up is important in pregnancies complicated with atypical endometrial hyperplasia, even if the disease goes into remission after delivery. |
| وصف الملف: | application/pdf |
| اللغة: | Japanese |
| تدمد: | 2187-1914 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=jairo_______::a1ceeb58a16fab9e539c76ecbf6b9fa5 http://hdl.handle.net/10271/00004093 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.jairo.........a1ceeb58a16fab9e539c76ecbf6b9fa5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21871914 |
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