直肠子宫内膜异位症恶变2例临床病理观察及分子特征分析

Malignant transformation of rectal endometriosis:a clinicopathological study and molecular analysis of 2 cases

子宫内膜异位症是一种常见的病变,而肠子宫内膜异位症恶变则较为罕见,主要临床表现为盆腔包块、腹部或盆腔疼痛、阴道出血、便血及肠梗阻等症状。在早期患者影像学检查中子宫内膜异位相关肠癌最常累及浆膜或浆膜下层,无黏膜病变或轻微病变,而晚期与原发性肠癌相似,易与肠原发腺癌混淆。本文收集直肠(性腺外)子宫内膜异位相关子宫内膜样癌2例,旨在探讨其临床病理学特征及分子学改变,并复习相关文献,以提高诊断医师的认识,避免误诊。

Endometriosis is a common disorder,while malignant transformation of endometriosis in the colon is rare.The main clinical manifestations include pelvic masses,abdominal or pelvic pain,vaginal bleeding,rectal bleeding,and intestinal obstruction.In early patients with endometriosis-related colon cancer,the most common involvement on imaging is the serosa or subserosa layer,with no mucosal lesions or minor lesions;while in advanced cases,it resembles primary colon cancer.This paper collected 2 cases of endometrioid carcinoma associated with rectal(extrinsic gonadal)endometriosis to investigate its clinicopathological features and molecular changes,and to review the relevant literature to improve the understanding of diagnostic physicians so as to avoid misdiagnosis.