Uterine sarcoma
Introduction
Introduction to uterine sarcoma Sarcomaofuterus is a group of malignant tumors originating from uterine smooth muscle tissue, uterine stroma, intrauterine tissue or extrauterine tissue. The histological origin is mostly the myometrium, or the connective tissue of the connective tissue or endometrium in the muscular layer. The incidence rate is about 20%-40%, more common in women 30-50 years old, sarcoma can be found in various parts of the uterus, the body is much more than 15:1 than the cervix. Uterine sarcoma accounts for 2-5% of uterine malignancies, and the age of good hair is about 50 years old, while cervical grape sarcoma is more common in young girls. Because there is no specific symptom in the early stage, the preoperative diagnosis rate is only 30-39%. For benign lesions of the pelvic cavity, radiation therapy should be avoided indiscriminately. Excessive exposure to radiation may lead to the occurrence of sarcoma and should not be ignored. In addition, due to the early detection and diagnosis of sarcoma is difficult, it is best to have a pelvic examination and other auxiliary examinations every half year for women before and after menopause. Women of any age, if there is abnormal vaginal secretions or lower abdominal discomfort, should be promptly examined. basic knowledge The proportion of illness: 0.0025% Susceptible people: women Mode of infection: non-infectious Complications: ascites
Cause
Cause of uterine sarcoma
Cause (80%):
The exact cause of uterine sarcoma is unknown. Some people think that it is related to embryonic cell residue and interstitial cell metaplasia. The history of pelvic radiotherapy and long-term stimulation of estrogen may be risk factors for the disease, but there is no clear evidence to prove the above. infer. Multiple primary, from the myometrium or uterine wall smooth muscle fibers.
Prevention
Uterine sarcoma prevention
For benign lesions of the pelvic cavity, radiation therapy should be avoided indiscriminately. Excessive exposure to radiation may lead to the occurrence of sarcoma and should not be ignored. In addition, due to the early detection and diagnosis of sarcoma is difficult, it is best to have a pelvic examination and other auxiliary examinations every half year for women before and after menopause. Women of any age, if there is abnormal vaginal secretions or lower abdominal discomfort, should be promptly examined. Strengthen exercise, enhance physical fitness, and improve immunity. Regular participation in physical exercise, such as health gymnastics, practicing Qigong, Tai Chi, doing radio gymnastics, walking, etc., is of great benefit. Anyone who insists on physical exercise will have a strong body and strong disease resistance, and rarely suffer from illness.
Complication
Uteral sarcoma complications Complications ascites
There are three main ways to transfer uterine sarcoma:
1, blood line spread is the main transfer route, through the blood circulation to the liver, lungs and other parts of the body.
2, sarcoma directly infiltrated, can directly invade the myometrium, and even reach the serosa layer of the uterus, causing dissemination and ascites in the abdominal cavity.
3, lymph node metastasis, less common in the early stage, more common in the late stage, more common in the degree of malignancy.
Symptom
Symptoms of uterine sarcoma Common symptoms Lower abdominal tenderness Vaginal blood secretions Vaginal secretions Increase abdominal vaginal irregular bleeding
1, abnormal vaginal bleeding: the most common symptoms, manifested as abnormal menstruation or vaginal bleeding after menopause. Accounting for 65.5% - 78.2%.
2, abdominal mass: more common in uterine fibroids sarcoma, the mass of the mass is rapidly increased, if the sarcoma grows into the vagina, it is often felt in the vagina. The uterus is often enlarged, the shape is irregular, and the texture is soft.
3, abdominal pain: is also a more common symptom. Due to the rapid growth of fibroids, the patient's abdomen is painful or painful.
4, increased vaginal secretions, can be serous, bloody or white, combined with infection can be purulent, foul odor.
5, if the tumor is large, you can compress the bladder or rectum with irritation, compression of the vein can occur lower extremity edema.
6, advanced patients may have weight loss, anemia, fever, systemic failure, pelvic mass infiltration of the pelvic wall, fixation can not move.
Examine
Uterine sarcoma examination
(1) B-ultrasound examination: It can display the internal structure of the uterine tumor, the edge condition and the low-resistance blood flow signal.
(2) preoperative diagnosis: low diagnostic rate of uterine leiomyosarcoma, high diagnostic value for endometrial stromal sarcoma and uterine malignant mesodermal mixed tumor.
(3) intraoperative cross-sectional specimens: uterine leiomyosarcoma preoperative diagnosis is less diagnosed, if the intraoperative section shows that the fibroids and muscle layer boundaries are unclear, the spiral structure disappears, showing raw fish-like, tissue is crispy Send fast frozen sections, but still rely on postoperative paraffin pathology to confirm the diagnosis.
Diagnosis
Diagnosis and diagnosis of uterine sarcoma
diagnosis
According to medical history, symptoms and signs, there may be a possibility of uterine sarcoma. For malignant mesodermal mixed tumors and most endometrioid stromal sarcomas, segmental curettage is an effective diagnostic method. Scrape out for pathological examination can confirm the diagnosis. The factor uterine sarcoma is complex, and the tissue is too small to be misdiagnosed as adenocarcinoma. Sometimes improper sampling can only be misdiagnosed or missed. If the sarcoma is located in the muscular layer and has not invaded the endometrium, it cannot be diagnosed by curettage alone. B-mode ultrasound and CT examinations can assist in diagnosis, but the final diagnosis must be based on pathological biopsy results. Surgical removal of uterine fibroids specimens should also be examined in detail, and if there is suspicious, frozen sections should be used to confirm the diagnosis. Uterine sarcoma is easy to metastasize to the lungs, so lung X-rays should be routinely performed.
Differential diagnosis
1, uterine leiomyosarcoma should be differentiated from uterine fibroids: uterine fibroids patients have no obvious symptoms, only occasionally found in gynecological examinations, or surgery. The main symptoms of uterine fibroids may have menstrual changes (increased menstrual flow, shortened cycle or prolonged menstruation, etc., may also have irregular bleeding), pain (generally no, but uterine fibroids have red degeneration or pedicle fibroids are reversed and Submucosal fibroids can cause acute abdominal pain when the uterus develops spasmodic contractions, and compression symptoms (fibroids compress the bladder), frequent urination, dysuria, and urinary retention. Uterine fibroids can cause hydronephrosis when they compress the ureter. The posterior wall of the uterus can squeeze the rectum, causing difficulty in stool, increased vaginal secretions, infertility, anemia (long-term menstrual flow can lead to secondary anemia).
2, endometrial stromal sarcoma and endometrial polyps, submucosal fibroids, as well as differentiation with intravenous leiomyomatosis, malignant potential undetermined leiomyomas, and ultimately rely on paraffin pathological examination for identification.
