腹膜播散性平滑肌瘤病5例临床分析及文献复习  

Clinical analysis of 5 patients with leiomyomatosis peritonealis disseminata

作　　者：沈明虹[1] 刘佳华[1] 孙阳[1] SHEN Minghong, LIU Jiahua, SUN Yang(Department of Gynecology, Fujian Provincial Hospital, Fuzhou 350001, Chin)

机构地区：[1]福建医科大学省立临床医学院福建省立医院妇科,福州350001

出　　处：《山西医科大学学报》2018年第3期273-276,共4页Journal of Shanxi Medical University

摘　　要：目的探讨腹膜播散性平滑肌瘤病的临床特点、诊断及治疗。方法回顾性分析2011-01-01~2015-12-31收治的5例LPD患者的临床特征、诊治经过及随访情况。结果 5例病例中4例有子宫肌瘤相关手术史。4例无自觉症状,以"盆腔包块"就诊,术前考虑盆腔肿物来源于卵巢可能性大,仅1例因"子宫肌瘤"就诊,有经量多表现。3例肿瘤生长于盆腔腹膜表面,2例肿瘤种植于膀胱及直肠表面脏腹膜。5例病例均行肿物切除术(腹腔镜/经腹);术后病理回报均符合平滑肌瘤。结论 LPD患者临床症状多不典型,术前容易误诊;LPD的临床治疗以手术为主(全子宫+双附件切除或肿瘤减灭术),辅以药物的治疗,如GnRHa及芳香化酶抑制剂等,以抑制肿瘤生长及降低复发。Objective To investigate the clinical features,diagnosis and treatment of leiomyomatosis peritonealis disseminata（ LPD）.Methods Five patients hospitalized with LPD from January 2011 to December 2015 in Fujian Provincial Hospital were collected. The clinical manifestations,treatment procedures and follow-up information of these patients were obtained and studied retrospectively. Results Of 5 cases,4 cases had surgical history related to uterine fibroids. Four patients had no subjective symptoms,and saw a doctor because of pelvic masses,and the other one patient had excessive bleeding and saw a doctor because of uterine leiomyoma. Tumors were located on the surface of the pelvic peritoneum in 3 patients,and in the visceral peritoneum of bladder and rectum in 2 patients.Five cases all underwent resections of the tumors by laparoscopy or laparotomy. Pathological reports of 5 cases were leiomyomas.Conclusion LPD patients manifests the atypical symtoms,and LPD is easy to be misdiagnosed. The main treatment way of LPD is surgeries,such as hysterectomy and bilateral salpingo-oophorectomy or debulking surgery. Adjunctive therapies may inhibit the growth of tumors and reduce recurrence of the disease,such as gonadotrophin-releasing hormone agonist（ GnRHa） and aromatase inhibitor（ AI）.

关 键 词：腹膜播散性平滑肌瘤病 子宫平滑肌瘤 腹腔镜子宫肌瘤剥除术 

分 类 号：R737.33[医药卫生—肿瘤]