자궁내 diethylstilbesterol 노출과 관련되지 않은 자궁경부 투명세포암 1예
A case of clear cell carcinoma of uterine cervix not related to intrauterine dietylstilbesterol exposure
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자궁경부에 발생하는 투명세포암은 자궁경부에서 발생하는 선암의 4~9%를 차지하는 비교적 드문 암으로, 임신 중 diethylstilbesterol (DES)에 노출되는 것이 확실한 원인 중 하나로 알려져 있으나, 모든 환자에서 DES 노출이 확인되지는 않는다. 저자들은 DES 노출이 없었던 67세 여성에서 발생한 자궁경부 투명세포암 1예를 경험하였으며, 환자는 처음에는 정상 자궁경부 육안 소견과 자궁내막 소파검사에서 발견된 조직검사 결과로 인하여 자궁내막암으로 진단되었으나, 이후 복강경적 전자궁절제술, 양측 자궁부속기절제술, 골반 및 대동맥주위림프절절제술 후 최종 조직검사에서 자궁내경부에 국한된 투명세포암으로 진단되었다. 환자는 수술 후 추가 항암화학방사선 동시요법을 받았다. 이에 저자들은 본 증례를 문헌 고찰과 함께 보고하는 바이다.
Abstract
Clear cell carcinoma of the uterine cervix is rare cancer that accounts for 4 to 9% of the adenocarcinoma of uterine cervix. Although intrauterine exposure to diethylstilbestrol (DES) during early pregnancy is one of the established risk factors, DES exposure may not be confirmed in all patients. We experienced a case of clear cell carcinoma in the uterine cervix of 67-year-old woman who was not exposed to DES. She was initially diagnosed as endometrial clear cell carcinoma because of the normal colposcopic finding and histologically proven clear cell carcinoma from endometrial aspiration biopsy and endocervical curettage. We performed a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and lymphadnectomy including both pelvic and para-aortic regions. On the final pathologic diagnosis of clear cell carcinoma confined to endocervix, the patient was received adjuvant concurrent chemoradiation with weekly cisplatin. We present the case with a brief review of related literature.
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