高悪性度子宮内膜間質肉腫肺転移の1例

Lung Metastasis from High-grade Uterine Endometrial Stromal Sarcoma；Report of a Case

はじめに　子宮内膜間質肉腫（ESS）はまれな疾患で，肺転移の手術報告は少ない．われわれは，両下肢深部静脈血栓症（DVT）と肺動脈血栓症（PE）を併発した巨大な子宮腫瘍で発見された高悪性度ESSとその肺転移に対する外科治療を経験したので，文献的考察を加えて報告する．

We report a rare case of surgical treatment for lung metastasis from high-grade uterine endometrial stromal sarcoma （ESS） with deep vein thrombosis （DVT） and pulmonary embolism （PE） in a 66-year-old woman. Chest computed tomography （CT） revealed 3 nodules of 3.9 cm, 3.3 cm, 1.2 cm in diameter in the left S6, S8, S9 of the lung. About 1 month after the hysterectomy following anticoagulant treatment with unfractionated heparin/warfarin, the patient underwent left lower lobectomy of the lung and lymph node dissection by video-assisted thoracoscopic surgery （VATS）. Microscopic and immunohistochemical examination showed that those tumors were metastases of high-grade ESS. The postoperative course was uneventful and adjuvant chemotherapy by ifosfamide, adriamycin, cisplatin was performed.