妊娠合并子宫血管周上皮样细胞肿瘤1例误诊分析  

Misdiagnosis of pregnancy with uterine perivascular epithelioid cell tumor:a case report

作　　者：杨敏[1] 李艳菊[1] 谢玲 张春莉[1] Yang Min;Li Yanju;Xie Ling;Zhang Chunli(Department of Pathology,The Affiliated Hospital of Yan’an University)

机构地区：[1]延安大学附属医院病理科,延安716000

出　　处：《重庆医科大学学报》2020年第5期697-700,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨子宫血管周上皮样细胞肿瘤(uterine perivascular epithelioid cell tumor,PEComa)的临床病理特征、诊断、鉴别诊断、治疗、预后及误诊原因,以减少误诊误治。方法:回顾性分析延安大学附属医院收治的1例PEComa误诊资料,并复习相关文献。结果:1例中年女性患者,因"停经39+5周,无腹痛要求住院分娩"入院,妊娠期间行B超检查提示:宫内妊娠、子宫肌瘤,于延安大学附属医院行子宫下段剖宫产术+子宫肌瘤剥除术。术后病理检查提示:子宫PEComa,术后随访24个月,现患者无瘤生存中。结论:子宫PEComa是较为少见的疾病,因其在影像学和临床上缺乏特征性表现而极易被误诊为子宫平滑肌瘤,确诊需病理学检查和免疫组化,手术治疗是目前有效的治疗方法,放化疗疗效尚无定论,术后需长期随访。Objective:To investigate the clinicopathological feature,diagnosis,differential diagnosis,treatment,prognosis and misdiag-nosis causes of uterine perivascular epithelioid cell tumor(PEComa),so as to reduce misdiagnosis and mistreatment.Methods:Misdi-agnosis data of one patient with PEComa admitted to our hospital were retrospectively analyzed,and relevant literatures were re-viewed.Results:A middle-aged female patient was admitted to the hospital due to“39+5 weeks of menopause,without abdominal pain,requiring hospitalization and delivery”.During pregnancy,ultrasound examination indicated:intrauterine pregnancy and uterine fi-broids.Cesarean section+laparoscopic myomectomy were performed in our hospital.Postoperative pathological examination sug-gested PEComa.Postoperative follow-up lasted for one year and the patient is now surviving without tumor.Conclusion:Uterus PEComa is a relatively rare disease,which is easily misdiagnosed as uterine leiomyoma due to its lack of imaging and clinical characteristics.The final diagnosis requires pathological examination and immunohistochemistry.At present,surgical treatment is an effective method;efficacy of chemoradiotherapy has not been determined.Long-term follow-up is required after surgery.

关 键 词：子宫血管周上皮样细胞肿瘤 子宫平滑肌瘤 误诊 

分 类 号：R737.33[医药卫生—肿瘤]