子宫平滑肌肉瘤盆腹腔广泛播散一例

A Case of Widespread Pelvic and Abdominal Dissemination of Uterine Leiomyosarcoma

子宫平滑肌瘤与早期子宫平滑肌肉瘤在临床表现及辅助检查方面很难鉴别,由于无瘤观念缺乏,在无保护措施下使用肌瘤分碎器,会增加子宫平滑肌肉瘤腹腔内播散的风险,并导致较差的预后。回顾性分析甘肃省妇幼保健院收治的1例患者腹腔镜下经分碎器行次全子宫切除术后出现腹胀,考虑为子宫平滑肌肉瘤盆腹腔广泛播散,行肿瘤细胞减灭术后辅助化疗的诊治经过。并对相关文献进行复习,从而充分认识无保护措施下腹腔镜肌瘤分碎的风险。

It is difficult to distinguish uterine leiomyoma from early leiomyosarcoma in terms of clinical manifestations and ancillary examinations.Due to the lack of tumor-free concept,the use of fibroid breakers without protective measures will increase the risk of intrapulmonary spread of leiomyosarcoma in the womb and results in a poor prognosis.The diagnosis and treatment of a case of abdominal distension after laparoscopic subtotal hysterectomy with a splitter in Gansu Provincial Maternity and Child-Care Hospital was retrospectively analyzed.It was considered that uterine leiomyosarcoma was widely spread in the pelvic and abdominal cavity,and the diagnosis and treatment of adjuvant chemotherapy after tumor cytoreduction was performed.And the relevant literature was reviewed,so as to fully understand the risk of laparoscopy myoma fragmentation without protective measures.