全子宮切除意外發現早期子宮內膜癌的病例報告

Accidental diagnosis of endometrioid endometrial cancer with ovarian preservation

子宮內膜癌的治療，一般均以手術為主，主要包括腹腔細胞學檢查，全子宮切除，雙側卵巢輸卵管全切除，及骨盆腔及或主動脈旁淋巴結取樣或廓清術。在非常年輕以及意外被發現的”早期”的子宮內膜癌患者，如果在手術時並沒有有發現是子宮內膜癌，所以只做了全子宮切除。那後續的治療，需不需要進行下一步的雙側卵巢輸卵管全切除已再加上適當的分期手術？或者採取嚴密追蹤即可，或者是還有其他的選項？這是值得深思的問題，最主要的原因是這類病人，預後極好，短時間內的復發也極為少見，所以在單純全子宮切除後，到底這些病人可不可以不再做任何手術，甚至保留卵巢，仍沒有一致的看法。本病例報告，就是介紹一位病患在接受全子宮切除後，意外被診斷為子宮內膜癌。

Surgery is a main step in the management of endometrial cancer, including washing cytology, total hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymph node dissection, and possible sampling. However, some young women with an accidental diagnosis of endometrioid endometrial cancer of the uterus after total hysterectomy for other supposed benign diseases. Therefore, what is the next step for these patients? There are many choices, including re-operation, re-staging surgery, bilateral salpingo-oophorectomy and other alternatives. Since the prognosis of such patients with early-stage and low-grade endometrioid endometrial cancers is excellent with fewer recurrences, the suggestion of observation with ovarian preservation is still debated. The following case report is show.