阔韧带肿瘤的手术诊断和病理类型

The surgical diagnosis value of broad ligament tumor and their pathological types

目的探讨阔韧带肿瘤的手术诊断价值和病理类型。方法 回顾性分析23例阔韧带肿瘤术前、手术诊断及病理特点。结果23例阔韧带肿瘤中仅1例术前诊断(4.35％),其中误诊为子宫肌瘤的9例(39.13％),误诊为卵巢肿瘤的13例(56.52％)。22例阔韧带肿瘤均为手术诊断(95.65％)。为阔韧带内间叶组织来源的肿瘤即为阔韧带真性肿瘤的17例(73.91％),为阔韧带囊肿的即非真性肿瘤的6例(26.09％),来源于阔韧带间叶组织的真性肿瘤占大多数,但两者差异无显著性(P>0.05)。恶性肿瘤2例,均为阔韧带肉瘤(8.70％),良性的1例(91.30％),其中发生玻璃样变性或粘液样变性的2例(8.70％),1例为神经鞘瘤。结论 阔韧带肿瘤的诊断主要以手术诊断为主,由于其组织来源不同,肿瘤表现为多样性,其中来源于Woffian氏管的阔韧带肿瘤具有恶性变的倾向,术后应密切随访。手术时应注意肿瘤基底部与输尿管、髂血管以及坐骨神经等的关系,慎勿损伤。

Objective To explore the surgical diagnostic value of broad ligament tumor and their pathological types. Methods 23 cases with broad ligament tumors were retrospectively analyzed for their diagnosis of pre - and post - operation and the characteristics of tumors ' pathologies. Results Only one case (4.35% ) was diagnosed correctly before operation. Most of them were misdiagnosed as myomas (39.13%) or ovarian tumors (56.52%) . In 22 cases (95.65%), broad ligament tumors were diagnosed by operation. 6 cases (26.09%) were diagnosed as cysts of broad ligament, whereas 17 cases (73.91%) whose tumor originating from the tissue of broad ligament belonged to true neoplasma. The former was less common than the later, but ther was no significant difference between them ( P > 0.05) . Malignant tumor - sarcoma of broad ligament was found in two cases (8.70%) . 21 cases (91.30%) were benign.Two out of 21 (8.70%) benign tumors showed mucinous or hyaline degeneration. 1 case was neurinoma. Conclusions The diagnosis of broad ligament tumor was mainly dependent on operation.B-ecause of the varied tissue origination of broad tumors, their manifestations were also different. Although the tumors from wolffian remnants demonstrated benign clinical course, however, recurrences and distant metastases had been reported. Therefore, such tumors should be followed- up carefully.In order to prevent surgical accidental injury the anatomicalassociations of ureter, iliac vessels and sciatic nerve with the base of the tumor should be paid attention to.