卵巢硬化性间质瘤的研究进展

Research Progress of Ovarian Sclerosing Stromal Tumor

卵巢硬化性间质瘤是一种临床罕见的卵巢良性肿瘤,其发病率低,病因不明确,以年轻女性多见,多为单侧肿块,常因月经不规则出血或体检发现腹部包块而就诊。影像学检查可见“湖岛征”、“快进慢出”和“向心性强化”等改变。病理组织学见单侧类圆形囊实性肿块,“假小叶”为特征性病变。免疫组织化学可见抑制素、波形蛋白和肌动蛋白等阳性表达。确诊主要通过病理组织学诊断,影像学检查具有重要参考价值。术前诊断困难,容易与卵巢纤维瘤、卵泡膜细胞瘤、卵巢库肯勃瘤和颗粒细胞瘤等相混淆。手术治疗为主要治疗手段,多采用患侧肿瘤切除术或附件切除术,术后预后较好,卵巢功能可恢复正常。对于肿瘤细胞出现核分裂象和坏死较多时,需警惕复发风险,建议长期跟踪随访。

Sclerosing stromal tumor of the ovary is a rare clinical benign ovarian tumor with low incidence and unclear etiology.It is more common in young women,mostly with unilateral mass,often visit a doctor due to irregular menstrual bleeding or abdominal mass found in physical examination.Imaging examination showed changes such as"lake island sign","fast in and slow out"and"centrality enhancement".Histopathology showed unilateral rounded cystic solid mass with"false lobule"as the characteristic lesion.Immunohistochemistry showed positive expression of inhibin,vimentin and actin.The diagnosis is mainly made by histopathology,and imaging examination has important reference value.Preoperative diagnosis is difficult and easily confused with ovarian fibroma,follicular membranous cell tumor,ovarian Kookenberg tumor,granulosa cell tumor,etc.Surgical treatment is the main means of treatment,mostly the affected side tumor resection or adnexectomy.Postoperative prognosis is good and ovarian function can be restored to normal.For the tumor with more nuclear mitosis and necrosis,it is necessary to be alert to the risk of recurrence,and long-term follow-up is recommended.