富于细胞型子宫平滑肌瘤术后复发伴腹膜播散一例  

A Case of Recurrent Cellular Uterine Leiomyoma with Peritoneal Dissemination after Surgery

作　　者：明扬 胡媛媛[2] 冯同富[3] MING Yang;HU Yuan-yuan;FENG Tong-fu(School of Medicine,Wuhan University of Science and Technology,Wuhan 430065,China;Training Base of Maternal and Child Health Hospital of Hubei Province,Hubei University of Medicine,Wuhan 430070,China;Department of Gynecology,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,China)

机构地区：[1]武汉科技大学医学部医学院,430065 [2]湖北医药学院湖北省妇幼保健院培养基地 [3]湖北省妇幼保健院妇科

出　　处：《国际妇产科学杂志》2024年第5期593-596,共4页Journal of International Obstetrics and Gynecology

基　　金：湖北省卫生和计划生育委员会青年项目(WJ2018H0158)。

摘　　要：富于细胞型子宫平滑肌瘤临床较为少见,与普通子宫肌瘤临床表现类似,术前常易漏诊。报道湖北省妇幼保健院收治的1例富于细胞型子宫平滑肌瘤患者,为其实施单孔无气腹子宫肌瘤剔除术。2022年6月因术后2年肌瘤复发,再次入院行腹腔镜下全子宫切除术和双侧输卵管切除术,术中发现盆腔腹膜、大网膜、结肠系膜、腹壁均有肿物,病理及免疫组织化学检查提示肿物均为富于细胞型子宫平滑肌瘤。术前需结合血流信号、影像学结果等方面综合考虑,以提高诊断率,术中全程注意无瘤原则和术后密切随访,以减少术后复发及医源性播散。Cellular uterine leiomyoma is relatively rare in clinical practice and often resembles the clinical presentation of common uterine fibroids,leading to frequent preoperative misdiagnosis.This report presents a case of a patient with cellular uterine leiomyoma treated at Maternal and Child Health Hospital of Hubei Province,who underwent a single-port gasless myomectomy.In June 2022,the patient was readmitted due to a recurrence of the leiomyoma two years post-surgery and underwent a laparoscopic total hysterectomy and bilateral salpingectomy.During surgery,tumors were found in the pelvic peritoneum,omentum,mesocolon and abdominal wall.Pathological and immunohistochemical examinations indicated that all the tumors were cellular uterine leiomyomas.Preoperative diagnosis requires comprehensive consideration of blood flow signals,and imaging results to improve diagnostic accuracy.During surgery,strict adherence to the principle of tumor-free techniques and close postoperative follow-up are essential to reduce the risk of recurrence and iatrogenic dissemination.

关 键 词：平滑肌瘤 平滑肌瘤病 腹腔镜 诊断 复发 

分 类 号：R737.33[医药卫生—肿瘤]