妊娠合并原发性卵巢肌瘤1例及文献回顾

Pregnancy complicated with primary ovarian leiomyoma:a case report and literature review

目的探讨原发性卵巢平滑肌瘤的流行病学及疾病特点、临床表现、鉴别诊断、辅助检查和治疗方法。方法分析榆林市第一医院2017年12月收治的1例妊娠合并原发性卵巢肌瘤患者的病史资料、治疗过程、病理检查及随访结果,并回顾卵巢平滑肌瘤及妊娠合并卵巢平滑肌瘤的相关文献。结果孕39周患者因"先兆子宫破裂"急诊行子宫下段剖宫产术,术中探查双附件,发现右侧卵巢大小约5cm×4cm×2cm实质性肿块,子宫体及左侧附件未见明显异常,术后病理组织学检测结果显示:右侧卵巢平滑肌瘤。该例患者术后42天再次来院复查,妇科检查、盆腔B超及血清CA125未见异常。结论原发性卵巢平滑肌瘤的发病率低,检出率低,不合并肉瘤样变性的患者预后较好。

Objective To investigate the epidemiology,disease characteristics,clinical manifestation,differential diagnosis,auxiliary examination and treatment of primary ovarian leiomyoma.Methods A patient with primary ovarian leiomyoma who was admitted to the First Hospital of Yulin in December 2017 was analyzed with her medical history,treatment process,pathological examination and follow-up results.And then the related literatures of ovarian leiomyoma and pregnancy complicated with ovarian leiomyoma were reviewed.Results This patient was treated with cesarean section at 39 weeks due to "threatened uterine rupture".Intraoperative investigation of the double adnexa revealed a solid mass in the right ovarian with size of about 5 cm × 4 cm × 2 cm,and no obvious abnormality was found in the uterine body and the left adnexa.The results of postoperative histopathological examination reported as right ovarian leiomyoma.The results of reexamination 42 days after the operation showed no abnormalities in gynecological examination,pelvic ultrasound and serum CA125.Conclusion The incidence and detection rate of primary ovarian leiomyoma are usually low,and patients without sarcomatoid degeneration might have a better prognosis.