@article{oai:hama-med.repo.nii.ac.jp:00003553,
 author = {柳原, 康穂 and 金田, 容秀 and 小熊, 響子 and 小林, 徹 and 伊藤, 早紀 and 松澤, 奈々 and 鵜野, しほり and 村瀬, 佳子 and 田中, 里美 and 矢田, 昌太郎 and 田中, 利隆 and 三橋, 直樹},
 issue = {1},
 journal = {静岡産科婦人科学会雑誌},
 month = {Mar},
 note = {子宮腺肉腫は良性腺上皮と肉腫成分からなる混合腫瘍で、治療は腹式単純子宮全摘術＋両側付属器摘出術が基本となる。今回若年発症の再発リスク因子の乏しい子宮腺肉腫FIGOⅠ期に対して、卵巣温存を行った1例を報告し、過去の文献より今後の再発リスク、卵巣温存について検討した。
症例は23歳 0妊。性器出血を主訴に救急外来を受診したところ、腟鏡診で腟内を占拠するポリープ様腫瘍を認めた。ポリープ摘出術を施行したところ、病理組織診断の結果はadenosarcoma without sarcomatous overgrowthであった。上記根治術を提示したが、患者が卵巣摘出を拒否したこともあり、卵巣温存を伴う手術療法を施行した。術後病理組織診断では筋層浸潤2 mmを伴う子宮腺肉腫FIGOⅠB期であった。文献上sarcomatous overgrowthは重要な再発リスク因子であり、また子宮腺肉腫Ⅰ期症例では卵巣温存の有無により予後に差がないと報告されている。Sarcomatous overgrowthがない若年発症子宮腺肉腫Ⅰ期症例では卵巣温存は考慮されるべきだと考えられる。, Uterine adenosarcoma is a mixed tumor consisted of benign glandular epithelia and sarcoma components. Treatment for uterine adenosarcoma basically includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. We report a case of FIGO stage I young-onset uterine adenosarcoma with no risk factors of recurrence which we conserved ovary for. In this case, we investigated recurrence risks of uterine adenosarcoma stage I and ovarian conservation by referring to past literature.
The patient is a 23-years-old nulligravida. She visited an emergency outpatient department due to genital bleeding; vaginoscopy showed a polypoid tumor occupying the vagina. The histopathologic examination of polypectomy showed that the tumor was adenosarcoma without sarcomatous overgrowth. We suggested the radical surgeries which were total abdominal hysterectomy and bilateral salpingo-oophorectomy. However, the patient rejected our suggestion and wished ovarian conservation. Total abdominal hysterectomy with bilateral salpingectomy had been performed to the patient. The pathological diagnosis was uterine adenosarcoma FIGO stageⅠB with 2 mm of myometrial invasion. Past literature has reported that sarcomatous overgrowth is an important risk factor of recurrence, and ovarian conservation does not impair prognoses of FIGO stageI young-onset uterine adenosarcoma. Ovarian conservation should be considered as one of treatment for FIGO stageⅠyoung-onset uterine adenosarcoma without sarcomatous overgrowth.},
 pages = {15--21},
 title = {卵巣温存をした若年子宮腺肉腫の1例},
 volume = {9},
 year = {2020}
}