阴道黏液表皮样癌一例

Mucous epidermoid carcinoma of the vagina: report of one case

原发于阴道的阴道黏液表皮样癌十分罕见。该文报道一例原发于阴道的黏液表皮样癌患者诊治经过。该例患者以发现阴道肿块4个月,进行性增大1个月为主诉,入院完善检查后予阴道肿瘤切除术。术后病理检查示其肿瘤组织主要由表皮样细胞、黏液细胞及中间型细胞构成,免疫组织化学染色示低分子量细胞角蛋白、高分子量细胞角蛋白等阳性表达,细胞增殖指数Ki-67约20%阳性,阿尔新蓝-过碘酸雪夫染色阳性。术后2周患者至外院进一步行近距离放射治疗及6个周期的辅助性化学治疗。随访显示患者恢复良好,无复发。原发性阴道黏液表皮样癌的预后与病理分型、临床分期及受累部位相关,除少数早期患者可手术切除外,多以放射治疗为主,辅以化学治疗。

Primary vaginal mucous epidermoid carcinoma( MEC) is extremely rare. Herein,we reported the diagnosis and treatment of one case of primary vaginal MEC. She had the chief complaints of vaginal masses for four months which were progressively enlarged for one month. After complete examinations,she underwent the resection of vaginal tumors. Postoperative pathological examination demonstrated that the malignant tumor tissues mainly consisted of epidermal-like cells,mucous cells and intermediate cells. Immunohistochemical staining revealed the positive expression of low-and high-molecular weight cytokeratin. Approximately 20% of the Ki-67 was positive. The AB-PAS staining yielded positive outcomes. At postoperative two weeks,she was transferred to another hospital and received brachytherapy and six cycles of auxiliary chemotherapy. Subsequent follow-up revealed the patient was well recovered without recurrence. The clinical prognosis of primary MEC is correlated with the pathological classification,clinical staging and involved sites. Surgical resection is recommended for a few patients with early primary MEC. Radiotherapy remains the primary approach,supplemented with chemotherapy.