子宫炎性肌纤维母细胞瘤复发及肺转移一例

doi:10.12280/gjszjk.20250654

摘要/Abstract

摘要：

子宫炎性肌纤维母细胞瘤（uterine inflammatory myofibroblastic tumor，UIMT）是一种极为罕见的间叶源性肿瘤，具有中间性生物学潜能。初诊易被误诊，且存在复发和转移风险。报告1例54岁女性，因检查发现子宫肿物在外院行腹腔镜下全子宫和双侧输卵管切除术，术后半年出现腹胀不适，经我院检查考虑盆腔肿瘤复发合并肺转移，行开腹盆腔粘连松解+盆腔肿物切除术，病理诊断为炎性肌纤维母细胞瘤，患者拒绝进一步治疗，术后2个月余出现肿瘤进展。UIMT的诊断主要依赖于免疫组织化学检查和辅助的分子检测，术前精准诊断有助于进一步制定诊疗计划，以期提高患者生存率。

关键词: 子宫肿瘤, 炎性肌纤维母细胞瘤, 肿瘤转移, 诊断, 治疗, 病例报告

Abstract:

Uterine inflammatory myofibroblastic tumor (UIMT) is an extremely rare mesenchymal tumor with intermediate biological potential. It is easily misdiagnosed at the initial presentation, with the risks of recurrence and metastasis. We report a case of a 54-year-old woman who underwent laparoscopic total hysterectomy with bilateral salpingectomy at another hospital after a uterine mass was detected. Six months after surgery, she developed abdominal distension and discomfort. Examination at our hospital suggested the recurrence of the pelvic tumor with pulmonary metastasis. She underwent an open pelvic adhesiolysis and pelvic mass resection, and the pathological diagnosis was inflammatory myofibroblastic tumor. The patient refused further treatment, and the tumor progressed more than two months after surgery. The diagnosis of UIMT mainly relies on immunohistochemical analysis and supplementary molecular testing. Accurate preoperative diagnosis is helpful for formulating a treatment plan, with the aim of improving the survival rate.

Key words: Uterine neoplasms, Inflammatory myofibroblastic tumor, Neoplasm metastasis, Diagnosis, Therapy, Case reports

伍博明, 陈紫均, 潘如, 罗裕, 杨海坤. 子宫炎性肌纤维母细胞瘤复发及肺转移一例[J]. 国际生殖健康/计划生育杂志, 2026, 45(3): 204-208.

WU Bo-ming, CHEN Zi-jun, PAN Ru, LUO Yu, YANG Hai-kun. Recurrence and Lung Metastasis of Uterine Inflammatory Myofibroblastic Tumor: A Case Report[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(3): 204-208.

图/表 5

图1 腹盆腔MRI图注：A、B MRI水平面，A为平扫图；B为增强图，黄色箭头所示为下腹-盆腔巨大团块状异常信号影，增强扫描欠均匀较前明显强化，内见多发斑片状、片状无强化区，边界尚清；C MRI矢状面，见肿物邻近肠管、膀胱受压移位。

图2 腹部超声图注：A 下腹-盆腔内见一混合回声肿物，呈类椭圆形（如箭头所示范围），边界尚清，回声不均，以实性稍高回声为主；B CDFI示肿物内实性部分可见较丰富条状血流信号。

图3 胸部CT图注：双肺见多发大小不一结节影，呈轻度欠均匀强化，左肺上叶及下叶见多发斑点状及条索状稍高密度影；左侧胸膜增厚、粘连。

图4 盆腔肿物病理图注：镜下大片坏死组织及黏液，内见少量肿瘤细胞呈梭形，核具有异型性，见少量核分裂象；HE染色×200，标尺=100 μm。

图5 盆腔肿物大体标本图注：肿物大小约18 cm×16 cm。

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