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頁籤選單縮合
題名 | A Successful Live Twin Birth by in Vitro Fertilization after Conservative Treatment of Recurrent Endometrial Cancer=復發性子宮內膜癌經藥物保守性治療及試管嬰兒治療後成功雙胞胎懷孕 |
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作者 | 吳憲銘; 賴瓊慧; 黃泓淵; 王馨世; 宋永魁; Wu, Hsien-ming; Lai, Chyong-huey; Huang, Hong-yuan; Wang, Hsin-shih; Soong, Yung-kuei; |
期刊 | 長庚醫學 |
出版日期 | 20080100、20080200 |
卷期 | 31:1 2008.01-02[民97.01-02] |
頁次 | 頁102-106 |
分類號 | 417.281 |
語文 | eng |
關鍵詞 | 子宮內膜癌; 復發; 黃體激素; 試管嬰兒; 懷孕; Endometrial adenocarcinoma; Recurrence; Megestrol acetate; IVF; Pregnancy; |
中文摘要 | 子宮內膜癌主要發生於停經後婦女,子宮全切除手術式子宮內膜癌的標準治療方式。子宮內膜癌於生育年齡女性並不常見。一般來說,一旦罹患子宮內膜癌,能夠成功懷孕的機會並不大。子宮內膜癌的形成機轉和動情激素的過度刺激有關。所以理論上,對於早期發現的子宮內膜癌,可以使用黃體激素(Megace)去除或是降低動情激素對子宮內膜的刺激作用,而達到治療的效果。我們報告一位子宮內膜癌復發第一期的35歲病人,由於她本身是一位不孕症的病人,所以能保留住子宮及生育能力的保守性藥物治療,遂成為治療的第一選擇。病人於接受黃體激素藥物治療後,進行試管嬰兒治療且成功懷孕產下雙胞胎。綜合以上所述,對於罹患早期子宮內膜癌的年輕婦女,且有意願生育的女性,使用黃體激素治療似乎是一項不錯的選擇。而在藥物治療後尚未懷孕以前,如果子宮內膜癌再度復發,子宮鏡檢查及追蹤,也扮演重要的角色。這個罕見的病例,經由子宮鏡檢查診斷出子宮內膜癌復發,立即進行第二次黃體激素藥物治療,控制子宮內膜癌復發,接著進行人工生殖試管嬰兒治療,最終成功雙胞胎懷孕生產。 |
英文摘要 | Endometrial cancer is predominately a postmenopausal disease. Endometrial cancer in women of childbearing age is relatively unusual. Endometrial cancer is typically treated with hysterectomy. After the development of endometrial cancer, successful pregnancy is rare. We present a case of recurrent stage I endometrial adenocarcinoma in a 35-year-old woman. Magnetic resonance imaging (MRI) revealed endometrial lesions without myometrium invasion and no pelvic lymph node enlargement. The patient refused surgical intervention with abdominal hysterectomy and bilateral salpingo-oophorectomy because of her essential desire for children. Fertility-preserving medical therapy with megestrol acetate for 1 year and subsequent assisted reproductive treatment (ART) were performed. Successful pregnancy occurred after in vitro fertilization-embryo transfer (IVF-ET). On the basis of these observations and the low malignant potential of well-differentiated endometrial carcinoma, fertility-preserving treatment using Megace therapy was suggested. In this case, recurrence occurred after the completion of Megace therapy and three failed attempts at artificial insemination by the husband (AIH). Recurrent endometrial adenocarcinoma was documented using hysteroscopy and direct endometrial biopsy. Another course of Megace therapy was administered due to her desire for children. A successful pregnancy occurred after long-term medical treatment and IVF-ET. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。