| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.46 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A hiperplasia mesonéfrica é uma entidade benigna pouco frequente, sendo encontrada, na
generalidade dos casos, de forma acidental, no colo uterino de mulheres assintomáticas. O
sistema de ductos mesonéfricos regride, habitualmente, durante o desenvolvimento
embrionário feminino, podendo permanecer estruturas vestigiais não funcionais, que se
acredita que sejam precursoras das lesões mesonéfricas hiperplásicas. O diagnóstico da
hiperplasia mesonéfrica baseia-se no exame histológico e imunohistoquímico de uma
amostra de conização cervical ou histerectomia, obtida no contexto de outra patologia que
pode surgir simultaneamente, e que não se relaciona diretamente com a lesão
mesonéfrica.
Neste estudo, descreve-se um caso clínico de uma doente do sexo feminino, de 48 anos de
idade, assintomática, encaminhada a uma consulta de Ginecologia no Centro Hospitalar
Universitário Cova da Beira (CHUCB) pelo Programa de Rastreio do Cancro do Colo do
Útero, por teste de HPV de alto risco e HSIL na citologia cervical. Neste contexto, foi
realizada biópsia cervical, dirigida por colposcopia, cujo estudo anatomopatológico
mostrou displasia de alto grau (CIN3), com ampla expressão do marcador p16. Foi
realizada, então, conização do colo do útero por ansa diatérmica, efetuando-se o
diagnóstico definitivo de lesão intraepitelial pavimentosa de alto grau (CIN3), associada a
hiperplasia de remanescentes mesonéfricos.
Tendo por base este caso clínico, realizou-se uma revisão da literatura existente sobre esta
entidade mesonéfrica, que mostrou que embora esteja bem caracterizada, pode ser,
erroneamente, reconhecida como um processo maligno, dada a sua ampla variedade de
formas de apresentação no colo uterino, pelo que é importante o seu reconhecimento.
Mesonephric hyperplasia is an infrequent benign entity, most often found incidentally in the cervix of asymptomatic women. The mesonephric duct system usually regresses during female embryonic development, and nonfunctional vestigial structures may remain, which are believed to be precursors to hyperplastic mesonephric lesions. The diagnosis of mesonephric hyperplasia is based on histological and immunohistochemical examination of a cervical conization or hysterectomy specimen obtained in the context of other pathology that may arise simultaneously, and that is not directly related to the mesonephric lesion. In this study, we describe a clinical case of a 48-year-old asymptomatic female patient referred to a Gynecology consultation at the Centro Hospitalar Universitário Cova da Beira (CHUCB) by the Cervical Cancer Screening Program for high-risk HPV testing and HSIL on cervical cytology. In this context, a colposcopy-guided cervical biopsy was performed, and the anatomopathological study showed high-grade dysplasia (CIN3), with ample expression of the p16 marker. A conization of the cervix was then performed using a diathermic loop, and the definitive diagnosis was made of a high-grade cervical intraepithelial lesion (CIN3) associated with hyperplasia of mesonephric remnants. Based on this clinical case, a review of the existing literature on this mesonephric entity was carried out, showing that although it is well characterized, it may be erroneously recognized as a malignant process, given its wide variety of presentation forms in the cervix, so its recognition is important.
Mesonephric hyperplasia is an infrequent benign entity, most often found incidentally in the cervix of asymptomatic women. The mesonephric duct system usually regresses during female embryonic development, and nonfunctional vestigial structures may remain, which are believed to be precursors to hyperplastic mesonephric lesions. The diagnosis of mesonephric hyperplasia is based on histological and immunohistochemical examination of a cervical conization or hysterectomy specimen obtained in the context of other pathology that may arise simultaneously, and that is not directly related to the mesonephric lesion. In this study, we describe a clinical case of a 48-year-old asymptomatic female patient referred to a Gynecology consultation at the Centro Hospitalar Universitário Cova da Beira (CHUCB) by the Cervical Cancer Screening Program for high-risk HPV testing and HSIL on cervical cytology. In this context, a colposcopy-guided cervical biopsy was performed, and the anatomopathological study showed high-grade dysplasia (CIN3), with ample expression of the p16 marker. A conization of the cervix was then performed using a diathermic loop, and the definitive diagnosis was made of a high-grade cervical intraepithelial lesion (CIN3) associated with hyperplasia of mesonephric remnants. Based on this clinical case, a review of the existing literature on this mesonephric entity was carried out, showing that although it is well characterized, it may be erroneously recognized as a malignant process, given its wide variety of presentation forms in the cervix, so its recognition is important.
Description
Keywords
Cérvix Hiperplasia Mesonéfrica Hsil Lesão Cervical Remanescentes Mesonéfricos