Müllerian腺肉瘤的临床及超声特点分析  

Analysis of Clinical and Sonographic Findings in Müllerian Adenosarcoma

作　　者：徐阳[1] 赵凡桂[1] 张浩[1] 任芸芸[1] 

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《实用妇产科杂志》2015年第10期762-765,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨Müllerian腺肉瘤（MA）的临床与超声特点。方法：回顾性分析复旦大学附属妇产科医院2007年11月至2014年7月25例经手术病理检查证实为MA患者的临床病史及超声表现。结果：125例MA患者平均年龄48.2±13.8岁,10例为绝经后妇女。主要临床表现为异常阴道流血（22例）,下腹痛（1例）及体检发现异常占位（2例）。病变部位在子宫内膜20例（80%）、宫颈3例（12%）、宫腔和宫颈1例（4%）以及盆腔内1例（4%）。16例单纯MA,5例伴性索样分化,4例伴肉瘤成分过度生长。其FIGO分期为ⅠA 8例、ⅠB 14例、ⅠC 1例,ⅢA 1例。2MA位于子宫的患者超声图像显示宫腔或（及）颈管内单个大小不等（最大径12~95mm,平均40.1±24.5mm）的息肉样占位,部分脱垂到阴道内（24例）;形态不规则,边界模糊（8例）或尚清晰（16例）;实性为主者22例（88%）,囊实性者2例（8%）,而1例（4%）位于盆腔内者是囊性为主、边界不清的低回声肿块。彩色多普勒血流显像：条索状血流信号7例,星点状血流信号者12例,彩色血流信号不明显者6例。结论：MA是一种少见的低度恶性肿瘤,其临床及超声表现无特异性,需要病理检查确诊。熟悉其临床及超声表现有助于加强对MA的认识,从而正确诊断。Objective：To investigate the clinical and sonographic characteristics of the müllerian adenosarcoma（MA）.Methods：The clinical data and ultrasonographic manifestations of 25 cases of müllerian adenosarcoma proved by operation and pathology in Obstetrics and Gynecology Hospital of Fudan University from November 2007 to July 2014 were retrospectively analyzed.Results：1The average age of 25 patients was 48.2±13.8years old.Ten cases were postmenopausal.The most common symptom of uterine MA was vaginal bleeding,but some patients presented with pelvic pain or abnormal mass revealed in routine examination.Uterine corpus was the most common primary site（20cases）,uterine cervix was the second site（3caes）,and pelvic was the rare site（1case）.There were 16 cases of pure MA,5cases of MA with Sex cord-like differentiation and other 4cases of MA with sarcomatous overgrowth.FIGO：eight patients had stageⅠA,14 had stage ⅠB,1had stage ⅠC and 1had stage ⅢA.2The most common appearance was a polypoid mass projecting into the endometrial cavity or endocervical canal in 24 cases,some cases prolapsed through the external os into the vagina.The tumor size ranged from 12 mm to 95mm（mean,40.1±24.5mm）.The surface of the tumor was irregular,and in 8masses,demarcation from underlying myometrium was poor,whereas the remaining 16 cases had a well-circumscribed margin.We observed 2distinct sonographic patterns in the uterus：completely solid（88%）and solid with cystic areas（8%）.The mass in the pelvic was predominantly cystic（4%）with poor demarcation.CDFI：Funicular blood flow signal was detected in 7cases,star punctiform blood flow signal was in 12 cases and no blood flow signal was in 6cases.Conclusions：MA is an uncommon neoplasm of low-malignant potential,which has no typical clinical and sonographic findings.However,familiarity with clinical and sonographic features of MA will help in enhancing the knowledge on MA and in suggesting the correct diagnosis of MA.

关 键 词：Müllerian腺肉瘤 子宫 彩色多普勒超声 

分 类 号：R737.33[医药卫生—肿瘤]