子宫内膜小细胞癌病例报告及文献复习

Small cell carcinoma of the endometrium:case report and literature review

目的:探讨子宫内膜小细胞癌组织起源,临床病理特点及治疗方法。方法:报道2例子宫内膜小细胞癌,并进行文献复习。结果:2例患者均有不规则阴道流血,术前诊断性刮宫病理诊断为子宫内膜分化差恶性肿瘤,行广泛性子宫、双附件和盆腔淋巴结切除,临床病理分期均为子宫内膜小细胞癌Ⅲc期,免疫组织化学诊断神经特异性烯醇酶(NSE)、突触素(Syn)呈阳性表达。病例1手术后未进行其他治疗,于手术后5月死亡;病例2手术后立即给予化疗和盆腔大野放疗,已无瘤生存2个月。结论:原发性子宫内膜小细胞癌极其罕见,具有较强侵袭性,预后差,手术、放疗及化疗等综合治疗可能改善预后。

Objective：To explore etiology of small cell carcinoma of endometrium and clinical,histopathologic and features of the disease.Methods：We reported two case of this rare tumor and reviewed the literature.Results：Both patients presented with vaginal bleeding.Both of them underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy.Two cases were stage Ⅲc according to postoperative pathology,Pathological examination revealed small cell carcinoma of endometrium Immunohistochemical evidence of neuroendocrine differentiation was demonstrated by using markers as neuron-specific enolase,synaptophysin.Case 1 died of her disease 5months after surgery,case 2 underwent chemotherapy combined with radiotherapy and was alive with no evidence of disease for 2 months.Conclusion：Primary small cell carcinoma of the endometrium is extremely rare and aggressive disease,The outcome is very poor,Surgery combined with chemotherapy and radiotherapy may contribute to an improved prognosis.