滋养细胞肿瘤误诊为宫颈妊娠1例报道  

Gestational Trophoblastic Neoplasia Misdiagnosed as Cervical Pregnancy: a Case Report

作　　者：马洁稚[1] 杨益民[1] 徐大宝[1] 万亚军[1] 薛敏[1] 

机构地区：[1]中南大学湘雅三医院妇科,湖南长沙410013

出　　处：《肿瘤药学》2016年第5期398-400,共3页Anti-Tumor Pharmacy

摘　　要：目的探讨滋养细胞肿瘤的临床特点,分析误诊原因。方法对我院误诊为宫颈妊娠的滋养细胞肿瘤1例的临床资料进行回顾性分析。结果本例因停经70天,清宫术后20天,阴道大量流血1天入院,急诊行双侧子宫动脉栓塞术,彩超及磁共振均提示子宫下段异常团块影,两次行宫腔镜下清宫术,病理诊断可见绒毛。术后查血β-HCG持续升高,复查磁共振子宫肌层内异常信号灶,考虑滋养细胞肿瘤。予以放线菌素-D单药化疗2次,HCG仍上升,改用EMA-CO方案化疗,监测HCG降至正常。结论滋养细胞肿瘤误诊为宫颈妊娠临床罕见,表现不典型。滋养细胞肿瘤易与特殊部位妊娠相混淆,宫腔镜及磁共振的应用具有特殊价值。Objective To analyze the misdiagnose cause according to the clinical features of the gestational trophoblastic neoplasia. Methods A retrospective analysis was conducted on a rare case of gestational trophoblastic neoplasia which was misdiagnosed as cervical pregnancy. Results A 35-year-old female patient was referred to the gynecology department because of a menelipsis for 70 days, and a massive vaginal bleeding for one day. The percutaneous angiographic embolization was done promptly, and the ultrasonographic examination and MRI both revealed a mass within the lower uterine segment. The patient received the curettage twice, but her serum beta- HCG increased continuously after the surgeries, and ultimately diagnosed with the gestational trophoblastic neoplasia. The monotherapy of actinomycine D responded an unsatisfactory result, so that we changed that into EMA-CO therapy, and then the serum beta-HCG has declined to normal level for more than three weeks. Conclusion The gestational trophoblastic neoplasia within the cervix has been rarely reported, and difficult to be acutely diagnosed. Hysterscope and MRI may contribute to the diagnosis.

关 键 词：滋养细胞肿瘤 宫颈妊娠 误诊 

分 类 号：R737.33[医药卫生—肿瘤]