胎盘部位滋养细胞肿瘤的临床病理诊断及一例误诊误治分析

Clinicopathological diagnosis of placenta site trophoblastic tumor and analysis of a case of misdiagnosis and maltreatment

随着我国生育政策的推进,医疗卫生部门及各级医院对于孕产妇及胎儿健康的关注程度随之加强。当前,婚检、唐氏筛查、大排畸等各种孕检、产检虽已基本普及,但仍有部分较为少见的围生期疾病初期症状不明显,且无较多临床影像学资料参考,导致误诊、漏诊,延误病情,如胎盘部位滋养细胞肿瘤(PSTT)。该疾病鲜少有文献资料研究,且临床表现无特殊性,为增进妇产科、肿瘤科临床相关医学从业者对此疾病的认知,提高诊治效率、准确度,本文报告了1例误诊、误治PSTT患者情况,分析讨论了PSTT的发病机制、临床特点、影像学表现、实验室检查和病理诊断标准、鉴别诊断要点、治疗和预后以及误诊原因,以期增加临床医生对该病的了解,提高警惕,防止误诊、误疗。

With the promotion of China's fertility policy,medical and health departments and hospitals at all levels pay more attention to maternal and fetal health.At present,although marriage examination,Down's screening,macro-anomalies and other kinds of pregnancy and obstetric examinations have been basically popularized,there are still some rare perinatal diseases with unremarkable symptoms at the initial stage and without more clinical imaging data for reference,which lead to misdiagnosis,omission of diagnosis and delay of the condition,such as placental site trophoblastic tumor(PSTT),which has rarely been studied in the literature and has no special clinical manifestations.There are few literature studies on this disease,and the clinical manifestations are not special.In order to improve the cognition of clinical practitioners in obstetrics and gynecology and oncology departments,and improve the efficiency and accuracy of diagnosis and treatment,this paper reports a case of misdiagnosis and mistreatment of PSTT.The pathogenesis,clinical features,imaging findings,laboratory examination and pathological diagnostic criteria,differential diagnosis key points,treatment and prognosis,and causes of misdiagnosis of PSTT were analyzed and discussed,in order to increase clinicians'understanding of the disease,raise vigilance,and prevent misdiagnosis and mistreatment.