盆腔腹膜后肿瘤临床病例分析  

Clinical analysis of patients with primary pelvic retroperitoneal tumor

作　　者：肖会廷 徐长骁 刘若妍 刘文欣 齐丽莎 张莉 王珂 Huiting Xiao;Changxiao Xu;Ruoyan Liu;Wenxin Liu;Lisha Qi;Li Zhang;Ke Wang(Department of Gynecologic Oncology,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin’s Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China;Department of Pathology,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin’s Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院妇科肿瘤科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,天津市300060 [2]天津医科大学肿瘤医院病理科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,天津市300060

出　　处：《中国肿瘤临床》2023年第15期786-790,共5页Chinese Journal of Clinical Oncology

基　　金：天津市教委科研计划项目(编号:2021KJ193);天津市医学重点学科(专科)建设项目(编号:TJYXZDXK-009A)资助。

摘　　要：目的:探讨盆腔腹膜后肿瘤(primary pelvic retroperitoneal tumor,PPRT)的诊疗及预后。方法:回顾性分析2000年10月至2021年5月于天津医科大学肿瘤医院诊治的31例PPRT患者的临床病理资料。结果:术前31例患者均行MRI或CT检查,7例提示肿物位于腹膜后,1例因肿物体积大且血管丰富,术前行超声引导下肿物穿刺确诊为肉瘤。31例患者均行手术治疗,其中良性肿瘤15例、恶性肿瘤16例。良性肿瘤以畸胎瘤(5/15)及神经鞘瘤(3/15)多见,良性肿瘤均完整切除;恶性肿瘤以肉瘤(9/16)多见,11例完整切除、5例姑息切除。胚胎残留组织来源的肿瘤均位于正中部位且良性多为囊性,间叶组织及神经组织来源肿瘤多位于侧位且多数具有实性成分。良性肿瘤患者的平均年龄为42.1岁,恶性肿瘤的为49.7岁。随访期内,15例良性肿瘤中14例未复发,1例复发后完整切除;16例恶性肿瘤中4例失访,4例死于该病,2例发生2次复发(2例均行手术),6例未复发。结论:PPRT易漏诊或误诊,鉴别诊断需结合临床特点、妇科检查及影像学检查。超声引导下肿物穿刺有利于在术前制定治疗方案,首选彻底手术切除方法。Objective:To analyze the clinical features,diagnosis,and treatment of primary pelvic retroperitoneal tumors(PPRT).Methods:The clinicopathological data of 31 patients with PPRT treated at Tianjin Medical University Cancer Institute&Hospital from October 2000 to May 2021 were retrospectively analyzed.Results:Preoperative magnetic resonance imaging(MRI)or computed tomography(CT)examination was performed in all patients.The results revealed that seven patients had retroperitoneal tumors.An ultrasound guided puncture was used to diagnose one patient before surgery owing to the large volume and abundance of blood vessels.All patients underwent surgical treatment,of whom 15 had benign tumors and 16 had malignant ones.Teratoma(5/15)and schwannoma(3/15)were the most common benign tumors,all of which were completely resectable.Sarcoma(9/16)was the most common malignancy,with complete resection in 11 cases and palliative resection in 5.The tumors originating from the fetal residual tissue were located in the median region and were mostly benign and cystic.Conversely,those originating from the mesenchymal and nerve tissues were mainly located in the lateral region and predominantly had solid components.The average patient ages for benign and malignant tumors were 42.1 and 49.7 years,respectively.During the follow-up period,14 out of the 15 cases of benign tumors showed no recurrence;one case underwent complete resection after recurrence.Of the 16 patients with malignant tumors,4 were lost to follow-up,4 died of the disease,2 had double recurrences(both underwent surgery),and 6 had no recurrence.Conclusions:Diagnosing PPRT is challenging,necessitating a comprehensive approach integrating clinical features,gynecological examination,and imaging for accurate differential diagnosis.Ultrasound-guided biopsy of the tumor facilitates the formulation of preoperative treatment,and complete surgical resection is the preferred treatment choice for this disease.

关 键 词：盆腔腹膜后肿瘤 盆腔包块 病理 诊断 鉴别诊断 治疗 

分 类 号：R730[医药卫生—肿瘤]