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子宫内膜小细胞神经内分泌癌一例并文献复习

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报告1例原发于子宫内膜的小细胞神经内分泌癌的病例。该患者为59岁女性,临床主要表现为绝经后阴道出血,血清肿瘤标志物未见明显异常。盆腔磁共振成像(magnetic resonance imaging,MRI)示子宫内膜增厚并信号异常,宫底、宫体结合带及肌层斑片状信号增高,弥散受限。该患者于2023年9月14日行单孔经脐腹腔镜经腹全子宫切除术+经腹双侧输卵管切除术+经腹双侧卵巢切除术+经腹膜后腹主动脉旁淋巴结清扫术+经腹双侧盆腔淋巴结清扫术+盆腔粘连松解术+脐整形术。截至2023年12月,患者已行4次化疗,一般情况良好,未发现复发及转移。子宫内膜小细胞神经内分泌癌恶性程度高、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。
Small Cell Neuroendocrine Carcinoma of the Endometrium:A Case Report and Literature Review
A case of small cell neuroendocrine carcinoma originating in the endometrium was reported.The patient was a 59-year-old woman with postmenopausal vaginal bleeding and no significant abnormalities in the level of serum tumor markers.Pelvic magnetic resonance imaging(MRI)showed the thickening of endometrium with abnormal signals,the increased signals of fundus uteri,the uterine body junction zone and myometria with limited diffusion.On September 14,2023,the patient underwent the single-hole transumbilical laparoscopic transabdominal total hysterectomy+transabdominal bilateral salpingotomy+transabdominal bilateral oophorectomy+retroperitoneal abdominal paraaortic lymph node dissection+transabdominal bilateral pelvic lymph node dissection+pelvic adhesion release+umbilical plastic surgery.As of December 2023,the patient has received four times of chemotherapy,the general condition was good,and no recurrence and metastasis were found.Endometrial small cell neuroendocrine carcinoma has a high degree of malignancy and poor prognosis,with non-specific clinical manifestations.Diagnosis mainly relies on pathological and immunohistochemical examinations.Early detection,diagnosis and personalized treatment are key to improving patient prognosis.

EndometriumCarcinoma,neuroendocrineCarcinoma,small cellDiagnosisTherapyPrognosis

王晶、王晓慧

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730000 兰州大学第一临床医学院

兰州大学第一医院妇产科,甘肃省妇科肿瘤重点实验室

子宫内膜 癌,神经内分泌 癌,小细胞 诊断 治疗 预后

2024

国际生殖健康/计划生育杂志
天津市医学科学技术信息研究所

国际生殖健康/计划生育杂志

CSTPCD
影响因子:0.694
ISSN:1674-1889
年,卷(期):2024.43(3)
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