伴有CA125及CA199异常增高的卵巢巧克力囊肿破裂1例  

Rupture of ovarian chocolate cyst with abnormal increase in CA125 and CA199 levels:a case report

作　　者：解军玉 姚红梅[2] XIE Junyu;YAO Hongmei(School of Clinical Medicine,Jining Medical University,Shandong,Jining 272000,China;Department of Gynecology,Affiliated Hospital of Jining Medical University,Shandong,Jining 272000,China)

机构地区：[1]济宁医学院临床医学院,山东济宁272000 [2]济宁医学院附属医院妇科,山东济宁272000

出　　处：《中国医药科学》2022年第22期186-188,192,共4页China Medicine And Pharmacy

摘　　要：卵巢巧克力囊肿破裂是妇科常见的急腹症之一,由于其起病急骤,术前明确诊断有一定困难,很容易发生误诊。通过查体、检测血清糖类抗原125(CA125)及CA199水平、超声和MRI等可以协助诊断子宫内膜异位症,但是腹腔镜下组织活检才是金标准。本文回顾性分析1例卵巢巧克力囊肿破裂的患者,破裂的囊肿导致大量腹腔积血,血清CA125及CA199浓度异常升高,分别为4153.8 U/ml和5496.63 U/ml,影像学检查提示左附件区混合性回声肿物、盆腔大量积液,腹腔穿刺抽出暗红色浓稠液体,被怀疑恶性肿瘤后行腹腔镜探查,术中及术后病理提示,卵巢子宫内膜异位囊肿破裂。当育龄期女性出现腹腔积血并伴有盆腔肿物时,除了考虑恶性疾病外,还应该考虑卵巢子宫内膜异位囊肿,在卵巢子宫内膜异位囊肿破裂的情况下,CA125及CA199可能会异常升高。Rupture of ovarian chocolate cyst is one of the common acute abdominal diseases in gynecology.Because of the rapid onset,it is difficult to make a definite diagnosis before operation,and such rupture is easy to be misdiagnosed.Physical examination,serum CA125 and CA199 levels,ultrasound,MRI,etc.can help diagnose endometriosis,but laparoscopic tissue biopsy is the gold standard.A case of rupture of ovarian chocolate cyst was analyzed retrospectively in this paper.The ruptured cyst caused a large amount of hemoperitoneum,and the serum CA125 and CA199 concentrations were abnormally elevated to 4153.8 U/ml and 5496.63 U/ml,respectively.The imaging examination showed a mixed echogenic mass in the left adnexal area and a large amount of pelvic effusion.The dark red,thick liquid was extracted by abdominal puncture,and laparoscopic exploration was performed after it was considered as suspected malignant tumor.Intraoperative and postoperative pathology showed that ovarian endometriosis cyst was ruptured.When women of childbearing age have hemoperitoneum and pelvic masses,in addition to malignant diseases,ovarian endometriosis cysts should also be considered.In the case of rupture of ovarian endometriosis cysts,CA125 and CA199 levels may be abnormally elevated.

关 键 词：CA125 CA199 卵巢巧克力囊肿 子宫内膜异位症 腹腔积血 

分 类 号：R711.71[医药卫生—妇产科学]