| 词条 | Uterine sarcoma |
| 释义 |
The uterine sarcomas form a group of malignant tumors that arises from the smooth muscle or connective tissue of the uterus. Signs and symptomsUnusual or postmenopausal bleeding may be a sign of a malignancy including uterine sarcoma and needs to be investigated. Other signs include pelvic pain, pressure, and unusual discharge. A nonpregnant uterus that enlarges quickly is suspicious. However, none of the signs are specific. Specific screening test have not been developed; a Pap smear is a screening test for cervical cancer and not designed to detect uterine sarcoma. HistologyTumoral entities include leiomyosarcomas, endometrial stromal sarcomas, carcinosarcomas and "other" sarcomas.[1]
DiagnosisInvestigations by the physician include imaging (ultrasound, CAT scan, MRI) and, if possible, obtaining a tissue diagnosis by biopsy, hysteroscopy, or D&C. Ultimately the diagnosis is established by the histologic examination of the specimen. Typically malignant lesions have >10 mitosis per high power field. In contrast a uterine leiomyoma as a benign lesion would have < 5 mitosis per high power field. ClassificationLeiomyosarcomas are now staged using the 2009 FIGO staging system[2] (previously they were staged like endometrial carcinomas) at time of surgery.
IA: ≤5 cm in greatest dimension IB: >5 cm
IIA: involves adnexa of uterus IIB: involves other pelvic tissues
IIIA: 1 site IIIB: >1 site IIIC: regional lymph node metastasis
Endometrial stromal sarcomas and uterine adenosarcomas are classified as above, with the exception of different classifications for Stage I tumors.
IA: limited to endometrium/endocervix IB: invades <½ myometrium IC: invades ≥½ myometrium Finally, malignant mixed Müllerian tumors, a type of carcinosarcoma, are staged similarly to endometrial carcinomas.[3]
IA: invades <½ myometrium IB: invades ≥½ myometrium
IIIA: invades uterine serosa and/or adnexa IIIB: vaginal and/or parametrial involvement IIIC: metastases to pelvic and/or paraaortic lymph nodes IIIC1: positive pelvic nodes IIIC2: positive para-aortic lymph nodes
ManagementTherapy is based on staging and patient condition and utilizes one or more of the following approaches. Surgery is the mainstay of therapy if feasible involving total abdominal hysterectomy with bilateral salpingo-oophorectomy. Other approaches include radiation therapy, chemotherapy, and hormonal therapy. Prognosis is relatively poor.[4] EpidemiologyUterine sarcoma are rare, out of all malignancies of the uterine body only about 4% will be uterine sarcomas.[5] Generally, the cause of the lesion is not known, however patients with a history of pelvic radiation are at higher risk. Most tumors occur after menopause. Women who take long-term tamoxifen are at higher risk.[6] See also
References1. ^{{cite journal |vauthors=Zagouri F, Dimopoulos AM, Fotiou S, Kouloulias V, Papadimitriou CA |title=Treatment of early uterine sarcomas: disentangling adjuvant modalities |journal=World J Surg Oncol |volume=7 |issue= |pages=38 |year=2009 |pmid=19356236 |pmc=2674046 |doi=10.1186/1477-7819-7-38 }} 2. ^http://www.ijgo.org/article/S0020-7292%2809%2900202-1/fulltext 3. ^{{cite web|url=http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/HealthProfessional/page3|title=Endometrial Cancer Treatment|date=1980-01-01}} 4. ^{{cite journal |vauthors=Gadducci A, Cosio S, Romanini A, Genazzani AR |title=The management of patients with uterine sarcoma: a debated clinical challenge |journal=Crit. Rev. Oncol. Hematol. |volume=65 |issue=2 |pages=129–42 |date=February 2008 |pmid=17706430 |doi=10.1016/j.critrevonc.2007.06.011 |url=http://linkinghub.elsevier.com/retrieve/pii/S1040-8428(07)00135-7}} 5. ^ American Cancer Society information, accessed 03-11-2006 6. ^ National Cancer Institute information, accessed 03-11-2006 External links
2 : Gynaecological cancer|Sarcoma |
| 随便看 |
|
开放百科全书收录14589846条英语、德语、日语等多语种百科知识，基本涵盖了大多数领域的百科知识，是一部内容自由、开放的电子版国际百科全书。