The Risk of Ovarian Cancer in Post-hysterectomy Hormones Therapy-A Case Report and Review of Literatures

子宮全切除後服用荷爾蒙與卵巢癌的相關性－個案報告及文獻回顧

黃國峰(Kuo-Feng Huang) ； 謝俊吉(Chun-Chieh Chia)

《中華民國婦癌醫學雜誌》 2004年1期 (2004/04) Pp. 35-40

https://doi.org/10.7010/JGO.200404.0035

摘要

目的：報告一個因子宮全切除後長期服用荷爾蒙併發卵巢癌的個案並且回顧一些文獻。病例報告：一位53歲女病人，G2P2，在7年前因子宮頸原位癌而行子宮全切除。三年前因出現更年期症候群而開始定期服用荷蘭蒙，最近卻因下腹痛來門診求診。我們內診及超音波發現其腹腔內有硬塊及腹水。電腦斷層顯示在兩側子宮附屬器有複雜物體，大網膜硬塊及大量腹水。腫瘤指數皆上升。手術發現腫瘤與腹腔臟器嚴重沾粘，無法做完整性減積手術。病理報告為腺癌合併大網膜轉移。在術後給於6次化療（paclitaxel及carbopltin），她得到完全康復。但是不幸，在化療結束後6個月，其腫瘤指數又開始上升。於是，我們再次給予paclitaxel及carbopltin的治療。結論：目前荷爾蒙療法與卵巢癌的關係仍然有爭議。大多數的文獻同意使用荷爾蒙10年或以上者，其得到卵巢癌的機會較高。在此提醒大家在子宮切除後荷爾蒙的給與應特別小心追蹤卵巢的變化。

關鍵字

子宮全切除 ； 荷爾蒙療法 ； 卵巢癌

並列摘要

We here report a case of ovarian cancer occurred 7 years after hysterectomy for carcinoma in situ of the cervix (CIS). A 53-year-old female, post-hysterectomy status, visited our department due to low abdominal discomfort. Tracing back her history, she had received estrogen therapy (ET) for 4 years after hysterectomy. The ultrasound and abdominal CT showed bilateral ovarian tumors, peritoneal carcinomatosis, ascites and bilateral pleural effusions. Debulking surgery was done for her and the final histopathological findings showed poorly differentiated serous carcinoma with diffuse omental implantation. 6 courses of adjuvant chemotherapy were given and complete remission was noted during chemotherapy. Unfortunately, the CA-125 rose 6 months after chemotherapy.As we know that ET may increase the risk of ovarian cancer after more than 10 years of usage, and we present this case in order to remind that regular adnexa survey after hysterectomy is necessary especially in those who received hormones therapy.

並列關鍵字

adjuvant chemotherapy ； CIS ； ovarian carcinoma