{"created":"2023-06-20T15:48:51.191605+00:00","id":3382,"links":{},"metadata":{"_buckets":{"deposit":"59132512-2289-4b52-a531-d473514be8d9"},"_deposit":{"created_by":4,"id":"3382","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3382"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003382","sets":["1:12:68"]},"author_link":["9921","9922","9923","9924","9925","9926","9927","9928","9929","9930","9931"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"86","bibliographicPageStart":"74","bibliographicVolumeNumber":"8","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"脱分化癌とは分化型成分と未分化成分を混在した組織型を特徴とし、婦人科領域では2006年にSilvaらによって提唱した新しい概念である.脱分化型類内膜腺癌はFIGO分類Grade3の類内膜腺癌より悪性度が高いとされている。今回術後24日で急速に死亡した子宮内膜脱分化型類内膜腺癌の症例を報告する。症例は41歳、来院時は子宮内腫瘍感染によりseptic shockを来しており全身集中管理を要した。手術は感染制御の目的で腹式単純子宮全摘術と両側付属器切除術を行った。病理組織診断はHE染色で類内膜腺癌Grade1(G1)の成分を15％認め、85%は単一で類円形、中型の異型細胞がびまん性に特異的配列を示さず増殖している所見で未分化癌に相当した。免疫組織化学検査において未分化癌領域はER、PgR、CAM5.2、CK7、CK20、p40、synapto-physin、chromogranin、SMA、CD10等すべて陰性で脱分化型類内膜腺癌と診断した。術後15日目の造影CTで骨盤内、肝臓、肺に多発病変を認め、術後24日目に多臓器不全で死亡した。脱分化癌は予後不良で、本例のように急激な転帰をたどる場合もあり注意を要する。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Dedifferentiated carcinoma is a novel concept proposed by Silva et al. in 2006 in the field of gynecology. Histologically, it is characterized by a mixture of differentiated and undifferentiated components. Differentiated endometrial carcinoma has a higher level of malignancy than grade 3 endometrial adenocarcinoma in the International Federation of Gynecology and Obstetrics classification. Here, we report a case of dedifferentiated endometrial adenocarcinoma where the clinical condition of the patient rapidly progressed to death on day 24 after surgery. A 41-year-old woman visited our hospital because of septic shock due to uterine tumor infection that required systemic intensive management. Aiming at infection control, the surgeries performed were total abdominal hysterectomy and bilateral salpingo-oophorectomy. The histopathological diagnosis based on the hematoxylin-eosin staining was a mixture of grade 1 (G1) endometrial cancer component (15%) and simple, round, medium-sized atypical cells (85%) that were proliferating without showing a sequence characteristic of a diffuse state and corresponded to undifferentiated cancer. Immunohistological tests revealed that ER, PgR, CAM5.2, CK7, CK20, p40, synapto-physin, chromogranin, SMA, CD10, and so on were all negative in the undifferentiated cancer region. As such, a diagnosis of dedifferentiated endometrial adenocarcinoma was made. Contrast-enhanced computed tomography performed on day 15 after surgery revealed multiple lesions in the pelvis, liver, and lungs. On day 24 after surgery, the patient died from multiple-organ failure. Dedifferentiated cancer has a poor prognosis, and there are cases where the outcome is rapid as in this case. Thus, management of the disease requires caution.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"静岡産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"21871914","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"加藤, 恵","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"市川, 義一","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"栗原, みずき","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"井関, 隼","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"安康, 真由香","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"江河, 由起子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鈴木, まり子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"服部, 政博","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"田代, 和弘","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"笠原, 正男","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"根本, 泰子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-03-26"}],"displaytype":"detail","filename":"jsog_8_1_74.pdf","filesize":[{"value":"3.5 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_8_1_74","url":"https://hama-med.repo.nii.ac.jp/record/3382/files/jsog_8_1_74.pdf"},"version_id":"0c8d0717-38b7-4370-ae3c-e93c46ac76e9"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Dedifferenciated endometorioid adenocarcinoma","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Undifferenciated adenocarcinoma","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"急激な転帰をたどった腹腔内膿瘍合併子宮脱分化型類内膜腺癌の臨床経過と病理像","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"急激な転帰をたどった腹腔内膿瘍合併子宮脱分化型類内膜腺癌の臨床経過と病理像","subitem_title_language":"ja"},{"subitem_title":"Dedifferentiated endometorioid adenocarcinoma of the uterus with abdominal abscess: Clinicopathological feature of a case","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["68"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2019-03-26"},"publish_date":"2019-03-26","publish_status":"0","recid":"3382","relation_version_is_last":true,"title":["急激な転帰をたどった腹腔内膿瘍合併子宮脱分化型類内膜腺癌の臨床経過と病理像"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T06:55:53.227210+00:00"}