以特鲁索综合征为首发表现的子宫内膜和卵巢双原发子宫内膜样腺癌的诊断及治疗(附1例报告)OA

Objective To summarize the effective diagnostic and treatment strategies for synchronous primary endom-etrioid adenocarcinoma of the endometrium and ovary with Trousseau syndrome(TS)as the initial manifestation.Methods The clinical data of a patient with synchronous primary endometrioid adenocarcinoma of the endometrium and ovary ini-tially presenting with Trousseau syndrome(TS)were retrospectively analyzed.Results A 47-year-old woman initially presented with headache,followed by multiple recurrent thrombotic events and imaging findings suggestive of malignancy,leading to suspicion of Trousseau syndrome(TS).Vaginal bleeding occurred after rivaroxaban anticoagulation,and enox-aparin was subsequently used for bridging anticoagulation.Neuroprotective therapy was also administered.After improve-ment of cerebral infarction symptoms,the patient received three cycles of paclitaxel plus carboplatin chemotherapy,fol-lowed by open total hysterectomy,bilateral salpingo-oophorectomy,omentectomy,and appendectomy.Surgeries went well.Postoperative pathology revealed moderately to poorly differentiated endometrioid adenocarcinoma of the right ovary and moderately differentiated endometrioid adenocarcinoma of the endometrium.Immunohistochemistry showed partial ER/PR negativity in the endometrial lesion and strong ER/PR positivity in the ovarian lesion.The patient was discharged in stable condition.Conclusions Synchronous primary endometrioid adenocarcinoma of the endometrium and ovary may present ini-tially with TS,and multifocal lesions may exacerbate its severity.Its diagnosis requires comprehensive evaluation of histopa-thology,molecular findings,and clinical manifestations.In the early stage,low-molecular-weight heparin-based anticoagu-lation may help balance thrombotic and bleeding risks,while surgery and chemotherapy should be undertaken,when feasi-ble,to reduce tumor burden to the greatest extent possible.