卵巢恶性苗勒管混合瘤超声表现1例

One case of ultrasonic manifestations of ovarian malignant mixed Mullerian tumor

卵巢恶性苗勒管混合瘤(ovarian malignant mixed Mullerian tumor,OMMMT)是一种罕见的、具有高度侵袭性的肿瘤。由于该病临床表现不典型,多数患者在晚期才确诊。为提高该病诊断符合率,并为临床治疗策略提供依据,现回顾性分析于2020年9月收入暨南大学附属广州红十字会医院的经手术病理证实的1例OMMMT患者的临床资料及超声表现。超声表现:盆腹腔见一混合回声肿块,长径超窗,横径161 mm,前后径111 mm,形态不规则,周边囊壁厚薄不均,内壁不光滑,肿块内部回声不均匀,内见无回声、粗细不均的高回声分隔带及不规则乳头状低回声突起,肿块与子宫颈关系密切,盆腔未探及正常子宫体及双侧卵巢回声。彩色多普勒血流显像:肿块周边及分隔带上探及条状血流信号,乳头状突起内可探及较丰富的血流信号,并探及动脉频谱,PSV 12.1 cm/s,RI 0.59。

Ovarian malignant mixed Mullerian tumor(OMMMT)is a rare and highly invasive tumor;most patients are diagnosed at an advanced stage due to its atypical clinical manifestations.To enhance the accuracy diagnosing the disease and provide a basis for clinical treatment strategies,a retrospective analysis of the clinical data and ultrasound images of the patient with OMMMT confirmed by operation and pathology at Guangzhou Red Cross Hospital,Jinan University in September 2020 was conducted.The ultrasound findings showed that a mixed echogenic mass was observed in the pelvic cavity,with a long diameter exceeding the viewing window,a transverse diameter of 161 mm,and an anteroposterior diameter of 111 mm.The mass exhibited an irregular shape and an uneven cystic wall with varying thicknesses around its periphery.The inner wall was not smooth,and the internal echogenicity of the mass was heterogeneous.Additionally,there were echogenic septa of varying thickness,irregular nodular hypoechoic protrusions,and non-echoic regions within the mass.The mass was closely associated with the cervix and there was no evidence of normal uterine or bilateral ovarian echoes during the examination.Color Doppler flow imaging showed strip-like blood flow signals on the periphery and septum of a palpable mass,and abundant blood flow signals within a nipple-like protrusion,with the detection of arterial spectrum signals;the PSV was 12.1 cm/s,and RI=0.59.