子宮内膜腫瘍が認められた完全中隔子宮、腟中隔に対し腹腔鏡下手術を行った一例

抄録

  Congenital anomalies of the uterus can result from developmental disorders of the Müllerian ducts. The precise incidence of congenital uterine malformations remains unclear, but the reported incidence is 4-5% of the general female population and it might be higher among patients with infertility or repeated miscarriages. Failure to resorb septa between the Müllerian ducts leads to the formation of a septate uterus, which, when combined with cervical duplication and a longitudinal vaginal septum, represents a rare congenital malformation. Although infertility is associated with uterine malformations, only a few reports have described endometrial neoplasia arising in patients with congenital uterine malformations.

  Endometrial polyps are caused by the localized overgrowth of endometrial glands and stoma through the uterine cavity, and they are associated with postmenopausal bleeding, infertility, and menorrhagia. The prevalence of malignancy with endometrial polyps is 0.52-3.5%. Risk factors for malignancy within polyps include ageing, obesity, arterial hypertension, postmenopausal period, and tamoxifen, which is a nonsteroidal anti-estrogenic agent that is a popular adjunctive therapy for women with breast cancer. Several reports over the past decade have indicated an increase in the incidence of endometrial abnormalities ranging from polyps to endometrial cancer in women undergoing treatment with tamoxifen.

  We describe a giant endometrial polyp in a complete septate uterus with longitudinal vaginal septum in an 81-year-old patient with breast cancer who had been treated with tamoxifen for 3 years and 7 months.