妊娠合并卵巢血管肉瘤1例并文献复习

PREGNANCY WITH OVARIAN ANGIOSARCOMA:A CASE REPORT AND LITERATURE REVIEW

目的探讨卵巢血管肉瘤的病理特征、诊断及治疗。方法对1例妊娠合并卵巢血管肉瘤病人的临床资料进行分析,并复习文献。结果病人为38岁妊娠期妇女,停经38 d,发现盆腔包块1 d,血清CA125升高,影像学无特异性改变,人工流产术后行经腹全子宫切除术+右侧附件切除术+盆腔淋巴结清扫术+腹主动脉旁淋巴结清扫术+大网膜切除术治疗,术后病理诊断为卵巢血管肉瘤。术后予吉西他滨+奈达铂两周期化疗。随访38个月未见肿瘤复发,病人仍存活。结论卵巢血管肉瘤是一种极为罕见的恶性肿瘤,其诊断依赖于病理检查结果,手术联合术后辅助化疗是其主要治疗方式。

Objective To investigate the pathological features,diagnosis,and treatment of ovarian angiosarcoma.Methods The clinical data of a pregnant patient with ovarian angiosarcoma was analyzed,and related literature was reviewed.Results The patient was a 38-year-old pregnant woman who had a menopause for 38 days.She was found to have a pelvic mass for one day and an increase of serum CA125,but no specific changes in the imaging.After an induced abortion,the patient underwent transabdominal total hysterectomy+right adnexectomy+pelvic lymph node dissection+para-aortic lymph node dissection+greater omentum resection,and was diagnosed with ovarian angiosarcoma after postoperative pathological diagnosis.The patient received chemotherapy with gemcitabine and nedaplatin for two cycles.After follow-up for 38 months,the patient survived without tumor recurrence.Conclusion Ovarian angiosarcoma is a rare malignant tumor whose diagnosis depends on pathological examination results.Surgery combined with postoperative adjuvant chemotherapy is the main treatment modality for the disease.