宫角异位型侵袭性葡萄胎一例  

A case of invasive hydatidiform mole of the ectopic type in the uterine horn

作　　者：冯露[1] 李均[1] 贺天文 胡辉权[1] FENG Lu;LI Jun;HE Tian-wen;HU Hui-quan(Department of Gynaecology,the Second Clinical Medical College of North Sichuan Medical College(Nanchong Central Hospital),Nanchong 637000,Sichuan,CHINA)

机构地区：[1]川北医学院第二临床医学院(南充市中心医院)妇科,四川南充637000

出　　处：《海南医学》2024年第19期2850-2852,共3页Hainan Medical Journal

基　　金：川北医学院科研发展基金项目(编号:CBY23-ZDA12,CBY23-QNA11)。

摘　　要：本文报道了一例异位侵袭性葡萄胎患者的临床特征、诊断过程及治疗方案。其人绒毛膜促性腺激素(β-HCG)提示24335 m IU/mL、超声提示左侧附件区异常回声(不除外滋养细胞疾病)及病检示(宫内组织)分泌期样宫内膜,左输卵管及左宫角、左阔韧带病灶查见水肿的绒毛组织并伴有滋养叶细胞增生,多系葡萄胎;免疫组化提示p53(+)、p57(-)、HCG(+),人胎盘碱性磷酸酶(PLAP)(-)、Ki-67(高表达),组织学类型符合完全性葡萄胎,CD34及弹力纤维染色提示一处血管内查见绒毛组织,符合侵袭性葡萄胎改变,确诊为侵袭性葡萄胎。治疗上采用了以手术为主、辅助化疗的综合治疗策略。This article reports the clinical features,diagnostic process,and treatment plan of a patient with ectopic invasive hydatidiform mole.With beta-subunit of human chorionic gonadotropin(β-hCG)of 24335 mIU/mL,ultrasound suggested abnormal echoes in the left adnexal region(trophoblastic disease was not excluded),and pathological examination(intrauterine tissue)showed villous edema and trophoblast hyperplasia in the endometrium,left fallopian tube,left uterine horn,and left broad ligament lesions.Hydatidiform mole was considered.Immunohistochemistry showed p53(+),p57(-),HCG(+),PLAP(-),Ki-67(highly expressed),and the histological type was found to be complete hydatidiform mole.CD34 and elastic fiber staining revealed villous tissue in one blood vessel,which was in line with the changes of invasive hydatidiform mole,and the diagnosis of invasive hydatidiform mole was confirmed.A comprehensive treatment strategy based on surgery with adjuvant chemotherapy was applied for treatment.

关 键 词：异位侵袭性葡萄胎 宫角 滋养细胞肿瘤 

分 类 号：R714.22[医药卫生—妇产科学]