输卵管畸胎瘤4例并文献复习

Tubal Teratoma: A Report of 4 Cases and Review of the Literature

目的:总结并分析输卵管畸胎瘤的临床特点及诊断。方法:对我院2010—2017年4例输卵管畸胎瘤及国内文献报道的25例病例进行回顾性分析。结果:29例输卵管畸胎瘤患者平均年龄35.17(24～60)岁,其中有妊娠史者占86.96%;肿瘤在左侧输卵管者占55.17%,右侧占44.83%,位于输卵管伞端及壶腹部者占72.41%。肿瘤的直径在0.3～15 cm,直径在6～10 cm者占54.17%。临床表现中有腹痛及盆腔包块症状者占72.41%。29例中无1例术前确诊,5例发生扭转,3例合并不孕。病理为成熟性畸胎瘤者占89.66%。我院4例中2例行输卵管肿物剥除术;剥除术后随访(1例随访6年、1例随访29个月)未见肿瘤复发;且其中1例术后3个月再次妊娠,1例术后至今未孕。结论:输卵管畸胎瘤临床特点无特异,易误诊,且存在扭转、恶变、不孕等风险,应及时进行治疗。

Objective:To summarize and analyze the clinical features and diagnosis of tubal teratoma.Methods:4 cases of tubal teratoma in our hospital from 2010 to 2017 years and 25 cases reported in domestic literature were analyzed retrospectively.Results:The average age of 29 cases of tubal teratoma was 35.17(24~60)years age,and the pregnancy history was 86.96%.The tumors occurred in the left side,55.17%,the right side,44.83%,and 72.41%in the fimbria and ampulla.The size of the tumor was between 0.3~15 cm,and 6~10 cm accounting for 55.17%.Abdominal pain and pelvic mass account for 72.41%.No cases were diagnosed before operation,5 cases were reversed,and 3 cases were infertile.Mature teratoma accounted for 89.66%.Of 4 cases in our hospital,2 underwent tubal mass stripping.The follow-up after stripping(1 cases followed up for 6 years,1 cases followed up for 29 months)showed no tumor recurrence,and one of them was subsequent pregnant after 3 months,and 1 case was not pregnant so far.Conclusions:The clinical features of tubal teratoma are nonspecific and easily misdiagnosed.There are torsion,malignant change,infertility and other risks,treatment should be timely.