@article{oai:hama-med.repo.nii.ac.jp:00003632,
 author = {望月, 琴美 and 柴田, 俊章 and 伊藤, 敏谷 and 小田, 智昭 and 安立, 匡志 and 成瀬, 香織 and 松家, まどか and 村上, 浩雄 and 中山, 毅 and 北村, 公也 and 伊東, 宏晃},
 issue = {2},
 journal = {静岡産科婦人科学会雑誌},
 month = {Oct},
 note = {帝王切開瘢痕部から発生する子宮体がんは極めて稀な疾患と考えられ、帝王切開瘢痕部の組織学的特性と子宮峡部癌の臨床的特徴および病理学的、遺伝学的特性を併せ持つ病態である。症例は54歳、3妊2産。2回の帝王切開術既往がある。子宮腺筋症に伴う月経困難症で前医に定期通院されていたが、子宮の病理学検査異常で当院紹介となった。子宮峡部前壁に発生する子宮体がんおよび子宮漿膜破綻を疑い、術前ⅢA期と診断し手術療法を行った。帝王切開瘢痕部の自然破綻を認め、子宮体がんⅢC1 期（類内膜癌、Grade2、pT3aN1M0）と診断した。術後再発高リスクのため補助化学療法を施行した。現在治療後1年経過し再発所見は認めていない。また、マイクロサテライト不安定性（MSI）検査は陽性であった。子宮峡部癌を含む帝王切開瘢痕部に発生する子宮体がんは様々な問題点が想起されるが、未だ病態解明が待たれる疾患であるため、今後の症例集積による知見の向上が期待される。, Endometrial cancer arising from caesarean section scars is an extremely rare disorder with the histological characteristics of caesarean section scars and the clinical, pathological, and genetic characteristics of endometrial cancer of the uterine isthmus. A 54-year-old woman with a history of three pregnancies (two caesarean sections) was being treated for dysmenorrhea associated with adenomyosis, and was referred to our hospital for abnormal pathological findings of the uterus. She was suspected of having endometrial cancer in the anterior wall of the uterine isthmus and rupture of the uterine serosa, preoperatively diagnosed as stage IIIA, and underwent surgery. She was diagnosed with stage IIIC1 endometrial cancer (endometrioid cancer, Grade 2, pT3aN1M0) with spontaneous rupture of caesarean section scar. Adjuvant chemotherapy was performed because of a high risk of postoperative recurrence. She has had an uneventful course after the surgery without recurrence for one year. The lesion was positive for microsatellite instability (MSI). Endometrial cancers, including that of the uterine isthmus, arising from caesarean section scars may cause various problems, although their pathology remains poorly defined. Further studies should be conducted in larger sample sizes.},
 pages = {37--45},
 title = {帝王切開瘢痕部から発生したと考える子宮体がんの１例},
 volume = {9},
 year = {2020}
}