卵巢类固醇细胞瘤误诊分析并文献复习

Misdiagnosis Analysis of Ovarian Steroid Cell Tumor and Review of Literature

目的探讨卵巢类固醇细胞瘤的临床特点、诊治方法、误诊原因及防范措施。方法对1例曾误诊的卵巢类固醇细胞瘤的临床资料进行回顾性分析。结果患者8年前出现闭经、脱发及多毛,6年前于外院诊断为肾上腺皮质增生症,行左侧肾上腺背部皮下移位术,术后病理检查示肾上腺网状带增生,术后症状无好转,就诊我院。左附件区可触及一实性肿物,睾酮等多项性激素指标升高,影像学检查示右侧肾上腺结合部小腺瘤或腺瘤样增生,地塞米松抑制试验及人绒毛膜促性腺激素兴奋试验提示卵巢来源肿瘤,予全子宫及双侧附件切除术,术后病理及免疫组织化学检查诊断为左卵巢类固醇细胞瘤(良性)。术后1个月复查性激素系列指标均改善,男性化症状和体征好转。结论提高对该病认识,临床遇及性激素异常,且影像学检查示卵巢肿物者,需仔细分析病情,进一步行功能性检查等,必要时行手术探查、病理和免疫组织化学检查,以减少误诊误治。

Objective To probed the clinical characteristics,diagnostic and treatment methods,misdiagnosis cause and prevent measures of ovarian steroid cell tumor. Methods Retrospectively analyzed the clinical data of 1 cases misdiagnosed of ovarian steroid cell tumor. Results 8 years ago,patients had amenorrhea,hair loss,and hairy hair. 6 years ago,was diagnosed adrenal cortical hyperplasia in the outer court,did left adrenal subcutaneous transposition,postoperative pathological examination showed adrenal reticular hyperplasia,after the postoperative symptom did not improve,visited our hospital. The left accessory area can reach a solid block,testosterone and other indicators of sex hormones elevated,imaging examination revealed of small adenoma or adenomatoid hyperplasia of the right adrenal gland,Dexamethasone inhibitory test and human chorionic gonadotropin excitatory test revealed ovarian origin tumor,gave the full uterus and bilateral adnexectomy,postoperative pathology and immunohistochemical examination were diagnosed as left ovary steroid cell tumor( benign). One month after surgery,the indexes of the sex hormone series were improved,signs of masculine symptoms improved. Conclusion Raised awareness of the disease,for sex hormone abnormalities,and imaging examination revealed ovarian tumor,should carefully analyze the illness,further functional examination and so on,when necessary gave surgical exploration,pathology and immunohistochemical examination,to reduce misdiagnosis and misdiagnosis.