一名肥胖妇女因严重贫血导致踝关节骨折,并伴有大量月经出血,在骨折后意外发现子宫内膜癌:病例报告。

IF 1.4 Q4 ONCOLOGY Molecular and clinical oncology Pub Date : 2024-11-06 eCollection Date: 2025-01-01 DOI:10.3892/mco.2024.2802
Hyung Joon Yoon, Tae Sik Go, Kyung Bin Kim, Yong Jung Song, Dong Soo Suh, Ki Hyung Kim
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引用次数: 0

摘要

子宫内膜癌(EC)是发达国家日益关注的公共卫生问题。子宫内膜癌的发病率正在上升,尤其是在年轻女性(2 岁以下)中。 在评估期间,计算机断层扫描发现了一个明显的子宫内膜肿块,怀疑是子宫内膜癌,于是她被转诊到作者所在的妇科。磁共振成像显示,她的子宫内膜肿块大小为 6.7 厘米,弥散受限,子宫肌层侵及子宫内膜。
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Endometrial cancer detected unusually after an ankle fracture secondary to severe anemia in an obese woman with heavy menstrual bleeding: A case report.

Endometrial cancer (EC) is a growing public health concern in developed countries. The incidence of EC is increasing, particularly in younger women (aged <50 years). Ankle fractures are relatively common orthopedic injuries, with the most common mechanisms being falls or trauma. A 36-year-old woman presented to the emergency department with right ankle pain secondary to a fall caused by dizziness and headache after menstruation. Initial radiography reveled a right ankle fracture without dislocation. Initial laboratory results revealed a hemoglobin level of 4.9 g/dl. She had a recent history of menorrhagia that lasted for two years. The body mass index was 36.2 kg/m2. During the evaluation, she was referred to the authors' gynecology unit after a computed tomography scan revealed a significant endometrial mass that was suspected to be EC. Magnetic resonance imaging revealed a 6.7-cm-sized endometrial mass with restricted diffusion, myometrial invasion of <1/2, and bilateral polycystic ovaries. The patient underwent open reduction and internal fixation involving screw fixation of a right ankle fracture. The postoperative follow-up showed successful healing and functional recovery. A total of 4 weeks later, robot-assisted total hysterectomy, bilateral salpingectomy and sentinel lymph node sampling were performed. Final histopathology revealed stage 1B, grade 2 endometrioid adenocarcinoma with lymphovascular space invasion. The patient received 50.4 Gy radiation to the whole pelvis. At 26 months of postoperative follow-up, the patient remained disease-free. The present case report describes a rare presentation of EC in an obese woman with heavy menstrual bleeding after ankle fracture secondary to severe anemia. The present case highlights the importance of assessing gynecological conditions through a detailed review of gynecological history with caution when an obese female patient presents with abnormal uterine bleeding, even during a non-gynecologic assessment.

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