TROPHOBLASTIC PSEUDOTUMOR OF UTERUS - EXAGGERATED FORM OF SYNCYTIAL ENDOMETRITIS SIMULATING A MALIGNANT-TUMOR
TROPHOBLASTIC PSEUDOTUMOR OF UTERUS - EXAGGERATED FORM OF SYNCYTIAL ENDOMETRITIS SIMULATING A MALIGNANT-TUMOR
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DOI：
10.1002/1097-0142(197609)38:3
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发表时间：
1976-01-01
期刊：
影响因子：
6.2
通讯作者：
NORRIS, HJ
中科院分区：
文献类型：
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作者：
KURMAN, RJ;SCULLY, RE;NORRIS, HJ
我们分析了12例先前未发现的子宫肌层假性肿瘤性滋养细胞侵袭。人绒毛膜促性腺激素(HCG)位于侵袭细胞的胞浆内。病变可能是局部性的，仅有表面或深度侵袭，肉眼可见切除的子宫内有肿瘤。在任何一种情况下，这一过程都被混淆为各种类型的恶性肿瘤，最常见的是绒毛膜癌，与之相区别的是缺乏典型的细胞滋养细胞和合体滋养细胞的二型性群体。大多数患者年龄从19岁到41岁不等，表现为闭经和子宫增大，被认为是怀孕了，尽管只有4人的妊娠测试呈阳性。最严重的并发症是子宫穿孔，其中1例为自发性穿孔，5例为刮宫时穿孔。一名患者因此死亡，但其他11名患者在确诊后0.5-12年内仍活着，没有疾病证据。在11名幸存的患者中，4名患者除刮宫外没有接受任何治疗。由于这种滋养细胞病变可能是良性的，在病理检查上类似于恶性肿瘤，因此选择了滋养细胞假瘤这一术语来命名它。
Twelve cases of a previously unrecognized pseudotumorous trophoblastic invasion of the myometrium were analyzed. Human chorionic gonadotropin (HCG) was identified by an immunoenzyme technique in the cytoplasm of the invasive cells. The lesion may be localized and only superficially invasive or deeply invasive and have a gross appearance suggesting a neoplasm in the excised uterus. In either case, this process has been confused with various types of malignant tumors, most often choriocarcinoma, from which it may be distinguished by an absence of the characteristic dimorphic population of cytotrophoblast and syncytiotrophoblast. Most of the patients, who ranged in age from 19-41 yr, presented with amenorrhea and uterine enlargement and were thought to be pregnant, although only 4 of them had positive pregnancy tests. The most serious complication was uterine perforation, which occurred spontaneously in 1 patient and during curettage in 5 others. One patient died as a result, but the other 11 are alive without evidence of disease 0.5-12 yr after the diagnosis. Of the 11 surviving patients, 4 received no treatment other than curettage. Because this trophoblastic lesion is likely benign and simulates a malignant tumor on pathologic examination, the term trophoblastic pseudotumor has been chosen to designate it.