原发性输卵管癌与子宫内膜癌同时癌误漏诊一例报告  

Primary Fallopian Tube Carcinoma with Endometrial Cancer at the Same Time: a Misdiagnosised and Missed diagnosised Report

作　　者：郜亚娟 简文文 曹隽 李理想 王鑫磊[1] 李卓 崔满华[1] 

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》2018年第1期38-40,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨原发性输卵管癌合并子宫内膜癌的临床特征、诊断要点、误漏诊原因及防范措施,提高鉴别诊断水平。方法回顾性分析1例原发性输卵管癌合并子宫内膜癌误漏诊病例资料。结果患者50岁,以盆腔包块伴右下腹疼痛半年为主诉。病程中先后2次就诊外院均未能明确诊断。入我院后影像学检查提示盆腔占位性病变,术前诊断:炎性包块?阑尾炎周围脓肿?行剖腹探查术,术中见右附件区肿物来源于输卵管,快速病理检查考虑为右侧输卵管浆液性癌(低分化),行经腹全子宫、双侧输卵管、卵巢、盆腔淋巴结、大网膜及阑尾切除术。术后病理检查确诊为:右侧输卵管癌ⅢC期、子宫内膜癌ⅠA期。给予紫杉醇+卡铂化疗8个疗程,随访10个月无复发。结论原发性输卵管癌同时合并子宫内膜癌较罕见,术前、术中易误漏诊,确诊依赖于病理免疫组织化学染色。Objective To investigate clinical features, diagnosed key points, treatment approaches and prognosis of patients with primary fallopian tube carcinoma and endometrial cancer at the same time in order to improve the level of differ-ential diagnosis. Methods Clinical data of one misdiagnosised and missed diagnosised case of primary fallopian tube carcino-ma and endometrial cancer was retrospectively analyzed. Results A 5 0 -year-old patient complained pelvic mass with right lower quadrant pain for six months. Two times in the course of treatment outside the hospital were unable to confirm the diagno-sis. The imaging examination suggested that it was occupying lesions in pelvis. Preoperative diagnosis was Inflammatory mass or appendicitis surrounding abscess. The patient underwent laparotomy. Intraoperative, the right attachment area neoplasm was from the fallopian tube. Rapid pathologic examination report the right fallopian tube serous carcinoma （poorly differentiated）. The patient underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic, lymphadenectomy, omentum resection and appendectomy . The postoperative diagnosis was stage III C Primary fallopian tube carcinoma and stage I A endometrial cancer. The patients received 8 cycles of chemotherapy of paclitaxel plus carboplatin and remained alive without evidence of recurrence during 6 months of follow-up. It is still being followed. Conclusion Primary fallopian tube carcinoma and endome-trial cancer is rare, and it is easily misdiagnosed and missed diagnosed in the preoperative and intraoperative diagnosis. Diag-nosis can be confirmed by pathological examination and immunohistochemical staining.[

关 键 词：输卵管肿瘤 子宫内膜肿瘤 肿瘤 多原发性 误诊 漏诊 

分 类 号：R657.32[医药卫生—外科学]