子宮脱の術後に判明した子宮体癌に対し、腹腔鏡下手術を追加した1例

Abstract

Objective: To describe an occult endometrial adenocarcinoma discovered unexpectedly after a vaginal hysterectomy performed for uterine prolapse.Design: Case reportPatient: a 52-year-old perimenopausal gravida 3, para 3 who presented with symptomatic pelvic organ prolapse.Intervention: a vaginal hysterectomy performed for uterine prolapse followed by a laparoscopic salpingo-oophorectomy.Results: The patient was preoperatively diagnosed with uterine prolapse, small myomas, and an endometrial polyp. Preoperative multiple endometrial samplings appeared normal except for the presence of an endometrial polyp. An early stage endometrial adenocarcinoma was discovered unexpectedly after a vaginal hysterectomy for uterine prolapse. Therefore, she underwent a laparoscopic bilateral salpingo-oophorectomy six weeks after the initial procedure. The pathologic findings showed no evidence of residual cancer. Two years postoperatively, there was no evidence of recurrence.Conclusions: In cases such as this, the patient must be informed of the possibility of recurrent disease when a laparoscopic bilateral salpingo-oophorectomy without the lymphadenectomy is chosen. In addition, the treatment of early stage endometrial adenocarcinoma by a vaginal hysterectomy followed by laparoscopic surgery may be one of the options for carefully selected patients who wish to undergo minimally invasive surgery.