原发性卵巢平滑肌瘤术前误诊浆膜下肌瘤分析并文献复习  

Preoperative Misdiagnosis of Primary Ovarian Leiomyoma as Subserous Myoma and Literature Review

作　　者：董洪果 聂思佩 郭玲 刘巧玲 倪娜 DONG Hongguo;NIE Sipei;GUO Ling;LIU Qiaoling;NI Na(Department of Obstetrics and Gynecology,the Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,China)

机构地区：[1]南京医科大学附属江宁医院妇产科,南京211100

出　　处：《临床误诊误治》2025年第8期1-5,共5页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金项目(82203117)。

摘　　要：目的探讨原发性卵巢平滑肌瘤(POL)的误诊原因及防范措施。方法回顾分析2024年5月收治的1例术前误诊子宫浆膜下肌瘤的POL患者临床资料。结果患者因自行扪及下腹部肿块10余天入院,术前超声检查提示子宫右侧低回声,考虑浆膜下肌瘤,经术中探查及术后病理检查最终确诊为POL。误诊时间2 d。予右侧输卵管卵巢切除术后患者恢复良好,术后1周痊愈出院。结论POL是罕见的卵巢良实性肿瘤,多数患者无症状,术前影像学表现亦无特异性,因此术前诊断困难,易误诊。临床医生应提高对POL的认识,遇到以附件区实性肿物就诊患者应考虑到该病可能,充分完善术前检查与评估,以减少误诊的发生。Objective To investigate the causes of misdiagnosis and preventive measures of primary ovarian leiomyoma(POL).Methods The clinical data of a POL patient who was misdiagnosed with subserous myoma before surgery in May 2024 were retrospectively analyzed.Results The patient was admitted to hospital due to self-palpable mass in the lower abdomen for more than 10 days.Preoperative ultrasound examination indicated low echo of the right side of the uterus.Considering subserous myoma,POL was finally confirmed by intraoperative exploration and postoperative pathological examination.The misdiagnosis lasted 2 d.The patient recovered well after right salpingo oophorectomy and was discharged at one week after recovery from surgery.Conclusion POL is a rare benign solid tumor of the ovary,and most patients have no symptoms and no specific preoperative imaging findings;therefore,preoperative diagnosis is difficult and it is prone to misdiagnosis.Clinicians should improve their understanding of POL,consider the possibility of the disease for patients with solid tumors in the adnexal area,and fully improve preoperative examination and evaluation to reduce the occurrence of misdiagnosis.

关 键 词：卵巢平滑肌瘤 原发性 误诊 浆膜下肌瘤 病理检查 鉴别诊断 

分 类 号：R737.31[医药卫生—肿瘤]