外阴平滑肌瘤8例临床分析  

Clinical Analysis of 8 Cases of Vulvar Leiomyoma

作　　者：许阡 成九梅[1] 安圆圆 XU Qian;CHENG Ju-mei;AN Yuan-yuan(Gynecology Minimally Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Bejing Maternal and Child Health Care Hospital,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院妇科微创中心,100006

出　　处：《国际生殖健康／计划生育杂志》2024年第6期467-470,484,共5页Journal of International Reproductive Health/Family Planning

摘　　要：目的:提高对外阴平滑肌瘤的认识及诊疗水平。方法:回顾性分析2009年1月--2023年12月首都医科大学附属北京妇产医院收治的经手术、病理确诊的8例外阴平滑肌瘤患者的临床病例资料,分析其临床特点、诊断、治疗及预后。结果:8例患者的平均发病年龄为37.8(27~46)岁。6例患者为自觉外阴肿物增大或外阴肿物持续存在就诊,其中1例患者外阴肿物伴隐痛,1例患者为外阴平滑肌瘤术后复发;另2例患者无明显临床症状。仅4例患者行会阴影像学检查,均未提示外阴平滑肌瘤。8例患者术前均未考虑外阴平滑肌瘤,术中行外阴肿物切除术或外阴局部扩大切除术,2例患者经石蜡病理诊断为外阴平滑肌瘤,另6例结合免疫组织化学最终确诊为外阴平滑肌瘤。术后随访6~158个月,未发现复发。结论:外阴平滑肌瘤是一种极为罕见的良性肿瘤,通常无症状,伴有较长时间的无痛性外阴肿胀或外阴肿物病史,影像学检查亦无特异性,术前多误诊为前庭大腺囊肿或脓肿。手术是目前主要的治疗方法,需完整切除平滑肌瘤及包膜,根据情况可酌情切除肿物边缘外部分正常组织以减少复发,术后需长期随访。Objective:To improve the diagnosis and treatment of vulvar leiomyoma.Methods:8 cases of vulvar leiomyoma admitted to the Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2009 to December 2023 were analyzed retrospectively,including their clinical characteristics,diagnosis,treatment and prognosis.Results:The average age of onset in 8 patients was 37.8 years(27-46 years).6 patients presented with an enlarged or persistent vulvar mass,including one patient with vague pain,one patient with recurrence of vulvar leiomyoma after surgery,and the other two patients with no obvious symptoms.Only 4 patients underwent perineal imaging,none of them were suggested vulvar leiomyoma.All 8 patients were not diagnosed as vulvar leiomyoma preoperatively,and were treated by the excision of vulvar mass or the localized enlarged vulvar excision.2 patients were diagnosed with vulvar leiomyoma by paraffin pathology,and the other 6 by immunohistochemistry.No recurrence was found in 6-158 months of postoperative follow-up.Conclusions:Vulvar leiomyoma is an extremely rare benign tumor,which is usually asymptomatic,being accompanied by a long history of painless vulvar swelling or vulvar mass.There is no specificity in imaging examination.Vulvar leiomyoma is often misdiagnosed as a Bartholin cyst or abscess before surgery.Surgery is the main treatment,which requires the complete excision of the leiomyoma and capsule.According to the situation,some normal tissues outside the edge of the tumor can be excised to reduce recurrence,and long-term follow-up is required after the operation.

关 键 词：外阴 平滑肌瘤 前庭大腺 诊断 治疗 

分 类 号：R737.35[医药卫生—肿瘤]