巨大卵巢幼年型颗粒细胞瘤一例误诊报告及文献复习  

A Report of One Misdiagnosed Patient with Giant Ovarian Juvenile Granulosa Cell Tumor and a Literature Review

作　　者：刘畅[1] 金月梅[1] 刘珊珊[1] 王秀秀[1] 王渠源[1] 邵艳萍[1] LIU Chang JIN Yue-mei LIU Shan-shan WANG Xiu-xiu WANG Qu-yuan SHAO Yan-ping(Department of Obstetrics and Gynecology, the Second Hospital of Jilin University, Changchun 130041, China)

机构地区：[1]吉林大学第二医院妇产科,长春130041

出　　处：《临床误诊误治》2017年第1期42-44,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨卵巢幼年型颗粒细胞瘤(juvenile granulosa cell tumor,JGCT)的临床病理特点、诊断要点及误诊原因,提高鉴别诊断水平。方法回顾性分析1例巨大卵巢JGCT误诊病例资料,并复习相关文献。结果患者20岁女性,因腹部渐隆起伴腹胀、食欲缺乏、尿频、月经紊乱入院,全腹CT检查示腹腔及盆腔内囊性占位性病变。查血癌抗原(CA)125 95.50 U/ml,CA199 8.4 U/ml,癌胚抗原0.78 ng/ml。诊断为腹腔肿物,剖腹探查术见一灰白色囊性肿物,底部与左侧输卵管相连,术中快速病理检查考虑为卵巢性索间质肿瘤,行左侧卵巢肿物切除+右侧卵巢楔形活检术。术后病理诊断为卵巢JGCT。术后予BEP方案化疗3个疗程,随访4个月,月经恢复正常,肿瘤无复发。结论JGCT是一种罕见的恶性肿瘤,术前、术中易误诊,确诊需依赖病理及免疫组化检查。Objective To investigate clinicopathologic features, diagnosed key points and misdiagnosed causes of giant ovarian juvenile granulosa cell tumor （JGCT） in order to improve the level of differential diagnosis. Methods Clinical data of 1 misdiagnosed patient with giant ovarian JGCT was retrospectively analyzed, and relevant literature was also reviewed. Results A 20-year-old female patient was admitted for abdominal bulge accompanied by abdominal distension, loss of appetite, urinary frequency and menstrual disorders. The whole abdomen CT suggested that it was cystic occupying lesions in ab- dominal and cavitas pelvis. The cancer antigen-125 （CA125） was 95.50 U/ml, and CA199 was 8.4 U/ml, and carcinoem- bryonic antigen was O. 78 ng/ml. Preoperative diagnosis was abdominal mass. A gray cystic mass was found by exploratory laparotomy, and its bottom was connected with the left tuba uterinauterine. Ovarian sex cord stromal tumor was suspected by rapidly pathological diagnosis during the operation. Resection of the left ovarian mass and a wedge biopsy of the right ovary were performed, and the postoperative pathological diagnosis was ovarian JGCT. All patients received postoperative chemotherapy with Bleomycin ＋ Etoposide ＋ Platinol （BEP） for 3 courses. The menstruation returned to normal without tumor recurrence during 4 months of follow-up. Conclusion Ovarian JGCT is rare, and it is easily misdiagnosed in the preoperative and intrao- perative diagnosis. Diagnosis can be confirmed by pathological examination and immunohistochemical staining.

关 键 词：卵巢肿瘤 颗粒细胞瘤 误诊 腹部肿瘤 

分 类 号：R737.31[医药卫生—肿瘤] R730.261[医药卫生—临床医学]