非HPV関連子宮内膜疣贅癌：1例の報告と文献レビュー

Non-HPV-related verrucous carcinoma of the endometrium: report of one case and review of literature.

• Di Sun
• Haiyang Jiang
• Ping Yang
• Ying Liu

抄録

子宮内膜疣贅癌の1例の臨床病理学的診断と治療法を分析し、関連文献と組み合わせてレビューと考察を行った。患者は67歳の閉経後女性で、分泌量の増加を伴う再発性膣出血を有していた。子宮腔腫瘍の総形態学および病理組織学は、疣贅癌の典型的な特徴的な変化を有していた。腫瘍背景には明らかな炎症があり、残留子宮内膜腺基底予備細胞には扁平上皮分化が認められた。腫瘍細胞免疫組織化学では野生型P53、P16は陰性発現、HPV分子検査は陰性であった。扁平上皮分化予備細胞ではp63の発現が陽性で、Ki67は高い増殖活性を示した。子宮内膜疣贅癌は、扁平上皮癌の特殊なサブタイプに属する悪性度の低い稀な腫瘍である。見逃されやすく、誤診されやすく、診断サイクルが長い。診断には臨床データ、画像診断、病理診断を組み合わせる必要があります。本疾患の病因は明らかではない。外科的治療が第一の治療法であり、臨床予後は良好である。

The clinicopathologic diagnosis and treatment of a case of endometrial verrucous carcinoma were analyzed, combined with the relevant literature for review and discussion. The patient was a 67-year-old postmenopausal woman who had recurrent vaginal bleeding with increased secretion. The gross morphology and histopathology of the uterine cavity tumor had typical characteristic changes of verrucous carcinoma. There was obvious inflammation in the tumor background and squamous differentiation in the residual endometrial gland basal reserve cells. Tumor cell immunohistochemistry showed wild-type P53, P16 negative expression and HPV molecular test was negative. The expression of p63 was positive in squamous differentiated reserve cells, and Ki67 showed high proliferative activity. Verrucous carcinoma of endometrium is a rare tumor with low malignancy, that belongs to a special subtype of squamous cell carcinoma. It is easily missed or misdiagnosed and has a long diagnosis cycle. The diagnosis should be combined with clinical data, imaging and pathology. The pathogenesis of the disease is not clear. Surgical treatment is the first treatment, and the clinical prognosis is good.

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