伴原发不孕症的子宫腺肉瘤临床病理分析

Clinical and pathological analysis of endometrial adenocarcinoma for infertile patients

目的探讨伴原发性不孕症的子宫腺肉瘤临床病理特点及误诊分析。方法观察分析2例伴原发不孕症的子宫腺肉瘤临床表现、病理特点。结果患者年龄分别为29岁和31岁,主要表现为不规则子宫出血及宫腔占位;组织学特征为良性子宫内膜腺体伴肉瘤性间质,其中1例合并有高级别子宫内膜间质肉瘤,另1例伴肉瘤成分过度生长。2例均采用全子宫+双侧附件+盆腔淋巴结清扫治疗,术后在随访中。结论子宫腺肉瘤常发生于中老年妇女,伴原发性不孕症的病例尚未见报道。作者认为,不孕症的原因除与宫腔占位有关外,下丘脑-垂体-卵巢轴的协调功能紊乱与不孕症和腺肉瘤的发生相关。

Objective To investigate the clinical pathological characteristics and misdiagnosis of endometrial adenocarcinoma for infertile patients. Methods Observation and analysis of 2 cases with primary infertility of uterine adenosarcoma clinical manifestations, pathological features. Results The age of the patients was 29 years old and 31 years old, mainly for irregular uterine bleeding and uterine cavity lesions;histological features with sarcomatous stroma of benign endometrial glands, of which 1 case with high grade endometrial stromal sarcoma, another 1 patient with sarcomatous component overgrowth. 2 patients underwent hysterectomy＋bilateral adnexa and pelvic lymph node dissection, in follow-up after operation. Conclusion Uterine sarcoma often occurs in the middle and old aged women, primary infertility cases have not been reported. The author thinks, cause of infertility is not only related to uterine cavity but also is related to the occurrence of the hypothalamic pituitary ovarian axis function disorder and infertility and prostate sarcoma.