青春期卵巢上皮性交界瘤7例临床分析

Ovarian epithelial borderline tumors in adolescent women:report of 7 cases

目的探讨青春期卵巢上皮性交界瘤的临床特点。方法回顾性分析本院2000年1月～2006年12月收治的7例20岁以下卵巢上皮性交界瘤患者的临床和病理特征。结果患者年龄16～19岁(平均17.8岁)。主要症状为腹胀5例(71.4%,其中3例伴腹痛)、腹痛4例(57.1%),盆腹腔包块,直径7～30cm(中位数20cm);B超检查盆腹腔囊实性包块6例,实性包块1例,直径7～32cm(中位数19.9cm)。根据术中冰冻病理检查情况,均采用保留生育功能手术(6例患侧附件切除术,1例卵巢肿瘤剔除术)。手术病理分期Ⅰa期卵巢粘液性交界瘤4例(57.1%),Ⅰa期浆液性交界瘤2例(28.6%),Ⅲc期浆液性交界瘤1例(14.3%)。随访18～94月(平均53.9月),6例(85.7%)无复发,1例Ⅰa期浆液性交界瘤患侧附件切除术后18月复发。结论青春期卵巢上皮性交界瘤Ⅰa期多见,病理类型为浆液性和粘液性肿瘤,各期患者保守手术治疗效果均较好。

Objective To investigate clinicopathological features of ovarian epithelial borderline tumors （EBT） in girls younger than 20 years. Methods Seven girls younger than 20 years with EBT were admitted to our hospital between Jan 2000 and Dec 2006. Their clinical and pathological data were retrospective studied. Results The average age was 17.8 years （range 16 to 19 years）. All cases were virgin and had regularly menstruation. The main symptoms were abdominal distention in 5 patients （71.4%, 3 of them accompanied by abdominal pain）, and abdominal pain in 4 （57, 1%） cases. They were found pelvic tumors by physical examination, with 7-30 cm （median 20 cm） in diameter. Cystic tumors with solid part were found in 6 of the 7 patients and a solid neoplasm was found in the other one by ultrasound. Frozen section examinations during operation were taken. All patients were treated by fertility - sparing surgery： 6 unilateral salpingo -oophorectomy and one by cystectomy. The postoperative diagnosis were ovarian mucous borderline neoplasm （MBT） FIGO Ia in 4 cases （57.1%）, ovarian serous borderline neoplasm （SBT） stage Ia in 2 cases （28. 6%）, and SBT stage ~c in 1 case （14.3%）. They were followed up for 18-94 months （average 53.9 months）. Six girls （85.7%） were alive free of disease and 3 of them were alive for at least 79 months. One patient with SBT stage I a treated by unilateral salpingo-oophorectomy recurred at the other ovary with staged Ⅲc SBT in 18 months. Conclusions , Most ovarian epithelial borderline tumors in young women are stage Ia SBT or MBT. Patients of all stage EBT treated by conservative management present good prognosis.