Endometrioid Endometrial Carcinoma With NKX3.1 Expression in a Transgender Man: A Case Report
Endometrioid Endometrial Carcinoma With NKX3.1 Expression in a Transgender Man: A Case Report
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跨性别男性中表达 NKX3.1 的子宫内膜样子宫内膜癌：病例报告
DOI：
10.1097/pgp.0000000000000869
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发表时间：
2023
影响因子：
2.4
通讯作者：
Kato Tomoyasu
中科院分区：
文献类型：
--
作者：
Yoshida Hiroshi;Uno Masaya;Ogimoto Keisuke;Kobayashi-Kato Mayumi;Tanase Yasuhito;Ishikawa Mitsuya;Kato Tomoyasu
跨性别男性中的子宫内膜癌很少见，其组织病理学特征仍不清楚。一名 30 岁的跨性别男性，患有宫内肿瘤、卵巢肿块，并有 2 年睾酮使用史，被转诊至我们接受治疗。通过影像学证实肿瘤的存在，并通过子宫内膜活检将子宫内肿瘤鉴定为子宫内膜子宫内膜样癌。患者接受了子宫切除术、双侧输卵管卵巢切除术、大网膜切除术和淋巴结清扫术。病理检查显示3级子宫内膜样子宫内膜癌，子宫内膜和卵巢同时发生的肿瘤统称为原发性子宫内膜癌。在卵巢和大网膜、盆腔腹膜和主动脉旁淋巴结中发现转移癌。免疫组织化学显示，肿瘤细胞广泛表达p53，保留PTEN、ARID1A、PMS2和MSH6的表达，并局部表达雌激素受体、雄激素受体和NKX3。 1.NKX3。 1也在宫颈外鳞状上皮内的腺体结构中表达。前列腺特异性抗原和前列腺酸性磷酸酶呈局灶性阳性。总之，我们描述了一名患有 NKX3 的跨性别男子。 1 表达子宫内膜样子宫内膜癌，他就睾酮对子宫内膜癌的影响以及跨性别男性的适当妇科护理提供了宝贵的建议。
Endometrial cancer in transgender men is rare, and its histopathologic features remain unknown. A 30-yr-old transgender man with an intrauterine tumor, an ovarian mass, and a 2-yr history of testosterone use was referred to us for treatment. The presence of the tumors was confirmed via imaging, and the intrauterine tumor was identified as an endometrial endometrioid carcinoma via endometrial biopsy. The patient underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node dissection. Pathologic examination revealed grade 3 endometrioid endometrial carcinoma, and the synchronous endometrial and ovarian tumors were collectively characterized as primary endometrial carcinoma. Metastatic carcinomas were discovered in both ovaries and the omentum, pelvic peritoneum, and a para-aortic lymph node. On immunohistochemistry, the tumor cells diffusely expressed p53, retained expression of PTEN, ARID1A, PMS2, and MSH6, and focally expressed estrogen receptors, androgen receptors, and NKX3. 1. NKX3. 1 was also expressed in glandular structures within the exocervical squamous epithelium. Prostate-specific antigen and prostatic acid phosphatase were focally positive. In conclusion, we describe a transgender man with NKX3. 1-expressing endometrioid endometrial carcinoma who provides valuable suggestions regarding the effects of testosterone on endometrial cancer and appropriate gynecological care for transgender men.