原发性输卵管癌一例误诊原因剖析

Primary Fallopian Tube Carcinoma,Misdiagnosis Analysis of One Case and Literature Review

目的探讨原发性输卵管癌的漏诊及误诊原因。方法对临床诊断为卵巢囊肿、术后病理诊断为原发性输卵管癌1例的临床资料进行回顾性分析并复习相关文献。结果本例因下腹坠胀2年,自觉尿频、下腹胀痛加重2 d入院。腹部超声检查示卵巢囊肿,行卵巢囊肿剥除术。术中见右侧输卵管增粗呈囊性团块状,与子宫角部分粘连,伞端闭锁;子宫及右侧卵巢外观正常,左侧输卵管伞端与卵巢粘连。行右侧输卵管切除术。术后病理诊断为输卵管原发性高级别浆液性腺癌。术后未行放化疗出院,在当地医院口服中药治疗,随访10个月未见复发。结论原发性输卵管癌是一种少见的妇科恶性肿瘤,术前诊断困难。提高对该病的认识并及时行经阴道超声检查能提高术前诊断率;术中快速病理检查是及时确诊的有效方法。

Objective The missed diagnosis and misdiagnosis of primary fallopian tube carcinoma was investigated. Methods For clinical diagnosis of pelvic mass, postoperative pathological diagnosis of primary fallopian tube carcinoma were analysed retrospectively. The clinical data and related literature were reviewed. Results The patient was admitted for fullness in the lower abdomen for 2 years, conscious urinating and abdominal pain aggravating for 2 days. Ovarian cyst underwent cyst removal surgery. Intraoperative enlargement of the right fallopian tube showed cystic mass block, uterine horn part adhesion, and umbrella end closure;Uterine and ovarian showed normal appearance on both sides of the ovary and oviduct umbrella end adhesion. Line of salpingectomy was on the right side. Postoperative pathological diagnosis was tubal primary high-level serous adenocarcinoma. No postoperative chemoradiotherapy was followed. The patient was given oral chinese herbal medicines. There was no recurrence during a 10-month follow-up. Conclusion Primary fallopian tube carcinoma is a rare malignant tumor of department of gynaecology and preoperative diagnosis is difficult to make. To improve the understanding of the disease and transvaginal ultrasound examination can improve the preoperative diagnostic rate;intraoperative rapid pathologic examina-tion is an effective method to confirm diagnosis.