论著-头颈部
以腹水为首发症状的卵巢幼年型颗粒细胞瘤1例及文献复习*
作者:马 亮1 庄 耘1 张力文2 丁炎波1 陈建平1
所属单位:1.苏州大学附属第三医院(江苏省常州市第一人民医院消化内科) (江苏 常州 213000)2.江苏省常州市第二人民医院 (江苏 常州 213000)
PDF摘要
目的 通过分析以腹水为首发症状的卵巢幼年型颗粒细胞瘤(JGCT)患者的临床资料,并查阅相关文献资料,为临床 诊断提供参考依据。方法 系统回顾1例以腹水为首发症状的JGCT患者的临床表现、腹水性质、影像学及腹腔镜下卵 巢肿瘤病变特征、治疗方法及预后,并结合相关文献复习讨论。结果 患者女,19岁,表现为进行性腹胀加重伴有 纳差不适,门诊B超提示腹盆腔大量积液,入院腹穿提示渗出液,淋巴细胞升高为主,腹水肿瘤及血清CA125显著升 高,雌二醇轻度升高,腹部CT示左侧附件区畸胎瘤,右侧附件区囊实性变?行腹腔镜探查及术后病理免疫组化示左 侧(卵巢)囊性成熟性畸胎瘤,右侧卵巢幼年型颗粒细胞瘤,分期为IC期,术后给予TP方案化疗,随访6个月至今, 无复发。结论 对以不明原因腹水为首发症状的年轻女性,需高度警惕JGCT可能,应常规进行妇科、盆腔超声或影 像学及腹腔镜检查,以及时诊断及治疗。
Objective To analyze the clinical data of patients with ovarian juvenile granulosa cell tumor (JGCT) with ascites as the first symptom, and to review the relevant literatures, and to provide reference for clinical diagnosis. Methods The clinical manifestations, ascites properties, imaging and laparoscopic ovarian tumor features, treatment methods and prognosis of ovarian JGCT patients with ascites as the first symptom were retrospectively analyzed and discussed with the literature review. Results A 19-year old girl showed an increase in progressive abdominal distension accompanied by anorexia discomfort and outpatient B ultrasound prompted a large number of pelvic pelvic fluid. The ascites nature of the patient was the effusion of lymphocyte elevation. Ascites tumor and serum CA125 Significantly increased. Abdominal CT showed left attachment area teratoma, right attachment area capsule solid change? Laparoscopic exploration confirmed that the patient's right ovarian pathology immunohistochemistry was juvenile granulosa cell tumor, stage for the IC period. Patients underwent TP regimen chemotherapy, followed up for 6 months to date without recurrence. Conclusion Taken together, we should be highly vigilant the juvenile granulosa cell tumor with massive ascites as the first clinical manifestation.
【关键词】卵巢幼年型颗粒细胞瘤;腹水;诊断
【中图分类号】R445.3;R737.3
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2019.03.016
前言
卵巢幼年型颗粒细胞瘤(ovarian juvenile granulosa cell tumor, JGCT)是性索间质肿瘤的 一个亚型,占卵巢颗粒细胞瘤的5%[1],其伴发腹水十 分罕见。本文将收治的1例以腹水为首发症状的卵巢 JGCT患者资料报道如下,并结合相关文献资料进行分 析。
罕少疾病杂志
第26卷, 第 3 期
2019年05月
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