产前胎儿肝脏间叶性错构瘤1例病例报告及文献回顾  

Prenatal fetal liver mesenchymal hamartoma:a case report and literature review

作　　者：黄贤苹 项慧秋 陈佳佳[1] 许张晔[1] 王荣跃[1] HUANG Xianping;XIANG Huiqiu;CHEN Jiajia;XU Zhangye;WANG Rongyue(Department of Obstetrics,The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院产科,浙江温州325027

出　　处：《重庆医学》2023年第3期338-342,共5页Chongqing medicine

基　　金：国家自然科学基金面上项目(81771555);浙江省医药卫生科技计划项目(2020KY641);浙江省温州市科技局项目(Y20190263)。

摘　　要：目的 探讨胎儿肝脏间叶性错构瘤(MHL)的产前影像学特点。方法 分析该院收治的1例胎儿先天性MHL的诊断经过并复习相关文献。结果 孕妇31+5周产前超声及磁共振发现肝脏肿块,误诊可能为“肝母细胞瘤或肝血管内皮瘤”,孕妇及家属在期待治疗过程中出现胎死宫内情况,住院引产,经病理检查确诊为MHL。包括本例在内,共获得国外报道MHL胎儿27例。27例患者诊断孕周15~38周,分娩孕周24~38周;肝脏肿块直径大小为2~16 cm;男性胎儿5例,女性胎儿16例,6例未报告性别;7例并发羊水过多,5例发生胎死宫内,死产1例,活产21例,4例新生儿出生后死亡;17例行手术切除治疗,随访10例预后好。结论 胎儿肝脏疾病在产前不具有特异性,围生期须进一步加强影像学检查、疑诊后的监测及产科管理,从而改善母儿预后。Objective To investigate the imaging features of prenatal fetal liver mesenchymal hamartoma(MHL).Methods The diagnosis process of one case of fetal congenital MHL admitted to this hospital was analyzed and related literature were reviewed.Results Prenatal ultrasound and magnetic resonance imaging of the pregnant at 31+5weeks found a liver mass, which may be misdiagnosed as “hepatoblastoma” or “hepatic hemangioendothelioma”.The Pregnant experienced intrauterine fetal death during the expectant treatment and was hospitalized to induce labor.The diagnosis of MHL was confirmed by pathological examination.Including this case, a total of 27 cases of MHL fetuses were obtained from domestic and international reports.The 27 patients were diagnosed at 15 to 38 weeks of gestation, and delivered at 24 to 38 weeks of gestation;the diameter of the liver mass was 2 to 16 cm.There were five male fetuses, 16 female fetuses, and six cases of unreported gender;seven cases were complicated with polyhydramnios, five cases had an intrauterine stillbirth, one case was a stillbirth, 21 cases were live birth, and four cases died after birth.A total of 17 cases underwent surgical resection, and 10 cases were followed up with a good prognosis.Conclusion Fetal liver disease is not specific in the prenatal period, and imaging examinations, post-diagnosis monitoring, and obstetric management should be further strengthened in the perinatal period to improve the prognosis of mother and child.

关 键 词：产前诊断 胎儿肝脏肿瘤 肝脏间叶性错构瘤 

分 类 号：R714.7[医药卫生—妇产科学]