RESUMEN
Between 1960 and 1995 the University of Leipzig Women's Hospital encountered 44 cases of primary malignant tumors of the Fallopian tube, including four malignant Müller mixed tumors and one sarcoma. The sarcoma, a dedifferentiated leiomyosarcoma, was found incidentally in a 57-year-old woman. Treatment encompassed total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy and pelvic and para-aortic lymph node dissection, followed by telecobalt irradiation of the pelvis (Hd 52 Gy). One year after treatment, no evidence of disease recurrence, is found. Literature documents only 34 cases of a primary uterine tube sarcoma. Even with RO-resection, the early, high rate of local recurrence (most often within the first two years after treatment) and hematogenous metastasis to the lungs, liver and bones compose this tumor's clinical course. The prognosis is poor despite the use of radiotherapy and/or combination chemotherapy.
Asunto(s)
Leiomiosarcoma/patología , Neoplasias Ováricas/patología , Femenino , Humanos , Histerectomía , Leiomiosarcoma/cirugía , Escisión del Ganglio Linfático , Persona de Mediana Edad , Epiplón/cirugía , Neoplasias Ováricas/cirugía , Ovariectomía , PronósticoRESUMEN
We report on a 50-year-old woman with a decompensated alcoholic liver cirrhosis and Korsakow syndrome since 1991. In July 1992, an abdominal hysterectomy with bilateral salpingoophorectomy was made because of an endometrial carcinoma pT1NOMO. A postoperative abscess of the vaginal stump was evacuated. The patient was admitted three years later with a massive vaginal bleeding. Her general appearance and nutritional status were bad. The vaginal bleeding was caused from ruptured varicose pelvic veins secondary to portal hypertension. Neither conservative (vaginal tamponade, infusions) nor operative (laparotomy with an intraabdominal and transvaginal tamponade) therapy was successful. The patient died as a result of severe bleedings. We discuss differential diagnostics and planning therapy.