低度恶性宫内膜间质肉瘤

Low Grade Malignant Endometrial Stromal Sarcoma. Three Cases Report

低度恶性宫内膜间质肉瘤很少见,本文报告3例,讨论其命名、分类和治疗。因本瘤有远处转移,晚期复发的特点,故强调长期随访的必要性。治疗以全宫及双附件切除为主,强调切除卵巢的重要性,因可使雌激素下降,肿瘤或复发灶缩小或消失。对放射治疗有一定敏感性。应用孕激素可使间质细胞蜕膜样变而获显著效果。化疗亦有一定疗效,可作为联合治疗方法之一。即使复发亦莫放弃治疗。

Low grade maligant endometrial stromal sarcoma is rare. This paper reports 3 cases. The definition, classification and treatment of this sarcoma are discussed. Long term follow-up is necessary because of its remote metastasis and recurrence. A total hysterectomy with bilateral salpingo-oophorectomy must be performed. Oophorectomy is important. It diminishes estrogen in the body and causes regression of the tumor itself or recurrent foci. This kind of tumor is sensitive to radiotherapy. Progestogen treatment is very effective in causing pseudodecidual reactions in the stromal cells. Chemotherapy is also effective and can be combined with other therapeutic modalities.