Extragenital adenomatoid tumour of the omentum: an unusual location

E. Skafida, A. Tsavari, K. Koulia, D. Myoteri, X. Grammatoglou, A. Zisi, M. Varras, T. Vasilakaki
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引用次数: 1

Abstract

Introduction Adenomatoid tumours are benig - n neoplasms that are mesothelial in origin and are usually confined to the genital tract and have rarely been reported at other sites such as the omentum, pleura, heart, liver, adrenal gland, retroperitoneum and intestinal mesentery. This paper discusses the unusual location of an extragenital adenomatoid tumour of the omentum. Case report We report the case of a 32-year-old woman who presented to our hospital with a four-day history of fever and pain in the right iliac fossa. Ultrasonography revealed a right ovarian cyst which was 2.5 cm in diameter and fluid in douglaseio. A right partial oopho - rectomy was performed, and duri - ng the operation, a well circu - mscribed mass measuring 2 cm was observed in the omentum. Histological evaluation of the cyst showed features of a cracked lute - al cyst and the mass showed feat - ures of an adenomatoid tumour. In the immunohistochemical study, the lesional cells were positive for calretinin, D240, CK5/6, HMBE1, CKAE1, CKAE3 and calponin. The treatment in such cases is tumour excision. W e report the case of an unusual extragenital adenomatoid tumour.
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子宫外网膜腺瘤样肿瘤:一个不寻常的位置
腺瘤样肿瘤是一种起源于间皮细胞的良性肿瘤,通常局限于生殖道,很少报道在其他部位如网膜、胸膜、心脏、肝脏、肾上腺、腹膜后和肠系膜。本文讨论了子宫外网膜腺瘤样肿瘤的异常位置。病例报告我们报告一名32岁的女性,她以四天的发烧和右髂窝疼痛史来到我们医院。超声示右侧卵巢囊肿,直径2.5 cm,腹腔积液。行右侧部分卵巢切除术,术中发现大网膜内有2厘米围合良好的肿块。囊肿的组织学检查表现为裂口黄体囊肿,肿块表现为腺瘤样肿瘤。免疫组化结果显示,病变细胞calretinin、D240、CK5/6、HMBE1、CKAE1、CKAE3、calponin阳性。在这种情况下的治疗是肿瘤切除。我们报告一个不寻常的病例外生殖器腺瘤样肿瘤。结论腺瘤样肿瘤常在外科手术中偶然发现。因此,肿瘤切除是首选的治疗方法。腺瘤样肿瘤是起源于间皮细胞的良性肿瘤,通常局限于生殖道。在男性中,这些肿瘤发生在附睾、睾丸被膜、前列腺、精索和睾丸实质。据报道,在女性中,这些肿瘤发生在子宫、输卵管,很少发生在卵巢1,2,3,4。然而,在其他部位,如网膜、胸膜、心脏、肝脏、肾上腺、腹膜后、肠系膜和淋巴结,也有罕见的生殖器外腺瘤样肿瘤的报道5,6,7,8。最初,它起源于1942年,但“腺瘤样肿瘤”一词是由Golden和Ash在1959年创造的。今天,从腺瘤样肿瘤的组织学、免疫表型和超微结构来看,腺瘤样肿瘤的间皮分化得到了很好的认识1,2,10。在本报告中,我们描述了腺瘤样肿瘤的另一个不寻常的位置。病例报告我们报告一名32岁的女性,她以4天的发烧和右髂窝疼痛病史来到我们医院。无恶性肿瘤家族史。实验室检查包括全血计数、生化检查和肿瘤标志物(CEA、Ca19-9、Ca125)均正常。超声及腹部及盆腔计算机断层扫描示右侧卵巢囊肿,直径2.5 cm,腹腔积液。行右侧部分卵巢切除术,术中发现大网膜内有2厘米围合良好的肿块。该囊肿的组织学检查显示为裂孔性黄体囊肿。在显微镜下,肿块具有可变的结构模式,包括囊肿、管状通道和由扁平或立方细胞排列的腺样空间。许多细胞具有空泡质和印戒状或成脂细胞样细胞形态。基质由疏松或致密的胶原组织组成,呈透明化。未见明显的细胞学异型性、肿瘤细胞坏死或有丝分裂象(图1[A]和1[B])。在免疫组化研究中,病变细胞calretinin、D240、CK5/6、HMBE1、CKAE1、CKAE3和calponin呈阳性(图2)。肿瘤的组织化学分析显示缺乏粘蛋白,这一特征有助于与转移性腺癌区分。基于以上特征性形态学及免疫组化表现,诊断为腺瘤样肿瘤。患者术后三年无复发。腺瘤样肿瘤的间皮起源被广泛接受,并得到电子显微镜和免疫组织化学研究的支持。然而,不同的作者提出了这些肿瘤的多种组织发生起源,包括间皮细胞、中肾细胞、勒勒细胞和内皮细胞的起源1,2,10。这些肿瘤在生殖器中明显占优势的原因*通讯作者Email: evelinaskafida@yahoo.gr 1希腊比雷埃夫斯“Tzaneion”综合医院病理学部2希腊雅典大学“kapodistriako”化学系3希腊雅典“Elena Venizelou”综合妇产医院妇产科第三科
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