術中迅速病理検査が術式決定に有用であった子宮体部筋層原発癌の1例

Case reports of primary uterine carcinomas mainly located at the uterine myometrium have been accumulated, and these tumors are considered to arise from adenomyosis. We report the case of a postmenopausal woman who presented with a uterine myometrial solid tumor measuring 23 mm in diameter. The tumor was initially considered to be a degenerated leiomyoma on MRI. The diameter of the tumor was enlarged to 43 mm one year later, and laparotomy was performed. Based on the intraoperative frozen section diagnosis of endometrioid carcinoma associated with adenomyosis, we performed total abdominal hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy and pelvic lymph nodes dissection. The tumor was histologically composed of endometrioid carcinoma associated with adenomyotic foci. The endometrium was intact. Recognizing the clinicopathological category of “primary uterine myometrial carcinoma”, which is characterized by association with adenomyosis and similarity to uterine mesenchymal tumor on imaging studies, may be clinically useful. Intraoperative frozen section diagnosis can help managing these uterine myometrial tumors with clinical features suggesting malignancy.