妊娠合并卵巢幼年型颗粒细胞瘤破裂一例  

Threatened pregnancy complicated with rupture of ovarian juvenile granular cell tumor: a case report

作　　者：陈洋[1] 李阳 吴富菊 Chen Yang;Li Yang;Wu Fuju(Department of Gynaecology and Obstetrics,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

出　　处：《新医学》2018年第9期687-690,共4页Journal of New Medicine

摘　　要：妊娠合并卵巢幼年型颗粒细胞瘤破裂临床上少见。该文报道了1例足月妊娠合并卵巢幼年型颗粒细胞瘤破裂患者的诊治经过。该患者27岁,孕_2产_0,停经39^(+3)周,因间断右下腹疼痛3 d、加重4 h入院,入院完善检查后行剖宫产术及剖腹探查术并分娩一健康男婴,术中在患者右侧卵巢可见一大小约8.0 cm×6.0 cm×7.0 cm、已破裂的肿物,术后病理回报符合幼年型颗粒细胞瘤,随后行保留生育能力的分期手术。术后予紫杉醇+顺铂方案化学治疗3个疗程,随访9个月,肿瘤未见复发。该例提示,足月妊娠已临产合并卵巢幼年型颗粒细胞瘤破裂诊断复杂,且术前、术中易误诊,治疗较为棘手,确诊需依赖术后病理及免疫组织化学染色检查。Pregnancy complicated with the rupture of ovarian juvenile granular cell tumor is rare in clinical practice. In this article, the diagnosis and treatment of a full-term pregnant women complicated with ovarian juvenile granular cell tumor rupture were reported. The 27-year-old patient （G2P0） was at 39 ＋3 weeks of gestation. She was hospitalized due to intermittent right lower abdonfinal pain for 3 d and aggravated for 4 h. After comprehensive exanfinations, she underwent cesarean section and laparotomy for laboring a healthy boy. Intraoperatively, a tumor of approximately 8.0 cm × 6. 0 cm × 7. 0 cm in size was detected in the right ovary. Postoperative pathological exanfination revealed the diagnosis of juvenile granular cell tumors. Subsequently, the patient underwent fertility-preserving staging surgery. She received 3 courses of postoperative chemotherapy （ paelitaxel plus eisplatin regimen） and was followed up for 9 months. No recurrent tumor was observed. This ease prompts that the diagnosis of full-term pregnancy complicated with the rupture of ovarian juvenile granular cell tumor is complicated, which is likely to make a misdiagnosis before and during surgery. The treatment of this disease is challenging. The diagnosis can be validated by postoperative pathological examination and immunohistoehemieal staining.

关 键 词：妊娠 先兆临产 卵巢肿瘤 颗粒细胞瘤 

分 类 号：R737.31[医药卫生—肿瘤]