腹腔鏡下子宮全摘術によって確定診断に至った漿液性子宮内膜上皮内癌の一例

抄録

　Serous endometrial intraepithelial carcinoma, a potential precursor to endometrial serous adenocarcinoma, may be challenging to diagnose through endometrial histology when the lesion is confined to a specific area. However, even in the absence of invasive carcinoma, metastasis may occur through the fallopian tubes. Therefore, early and reliable diagnosis and appropriate treatment are important. Here, we describe a case of serous endometrial intraepithelial carcinoma, diagnosed via laparoscopic total hysterectomy, in which the diagnosis was difficult despite the initial suspicion of serous carcinoma. The 57-year-old patient was referred to our hospital because of genital bleeding and abnormal endometrial cytology results. Endometrial histology was insufficient to confirm a diagnosis of serous carcinoma, and computed tomography and magnetic resonance imaging scans revealed no abnormalities. The patient underwent bilateral adnexectomy, which did not reveal any lesions, followed by laparoscopic total hysterectomy and the subsequent diagnosis of serous endometrial intraepithelial carcinoma. The patient received postoperative chemotherapy and is alive without disease. Our case highlights that, in cases of cytological abnormality or irregular genital bleeding, a thorough search must be conducted, including via total hysterectomy, even when histological examination does not reveal any abnormalities.