单侧卵巢原发性去分化脂肪肉瘤1例报告及文献复习

doi:10.13481/j.1671-587X.20230427

摘要/Abstract

摘要：

目的分析原发性卵巢去分化脂肪肉瘤（DDLPS）患者的临床特点和诊治经过，以加深临床医生对该病的认识并提高其诊治水平。方法收集1例原发性卵巢DDLPS患者的临床资料，分析其临床病理特征、诊断、鉴别诊断、治疗和预后，并对相关文献进行复习。结果患者，女性，63岁，因发现下腹部巨大包块半个月入院。妇科超声，子宫切除术后，盆腔正中见17.0 cm×9.3 cm实性低回声，形态欠规则，界限清，周边见血流信号，双卵巢未探及。全腹CT检查，盆腔内见巨大团块状混杂密度影，可见分叶，边界欠清，大小约132 mm×86 mm，CT值约为33 HU，增强扫描病灶明显不均匀强化，边缘强化明显，其内低密度影未见明显强化；盆腔见多发且直径小于6 mm淋巴结影，CT增强扫描见淋巴结轻度强化。肿瘤标志物未见明显异常。诊断为盆腔肿物，卵巢恶性肿瘤可能性大。完善相关检查后限期在全麻下行经腹双侧输卵管和卵巢切除术。术后病理诊断为卵巢DDLPS。患者术后随访10个月未见复发。结论原发性卵巢DDLPS较为罕见，临床表现无特异性，影像学检查有助于诊断，根治性手术是其主要治疗手段，靶向治疗可提高疗效，该病恶性度高，预后差，易复发，术后应长期随访。

关键词: 卵巢肿瘤, 原发性, 去分化脂肪肉瘤, 预后

Abstract:

Objective： To analyze the clinical characteristics and diagnosis and treatment of the patient with primary ovarian dedifferentiated liposarcoma （DDLPS）， and to improve the clinicians’ understandings of the disease and the levels of diagnosis and treatment. Methods The clinical data of one patient with primary ovarian DDLPS was colected，and the clinicopathological manifestations， diagnosis， differential diagnosis， treatment， and prognosis were retrospectively analyzed， and the related literatures were reviewed. Results A 63-year-old female patient was admitted to hospital because of a huge mass in the lower abdomen for half a month. The gynecological ultrasound results showed there was a solid hypoechoic mass，with the size of 17.0 cm × 9.3 cm， with an irregular shape and a clear boundary in the middle pelvic cavity after hysterectomy， and there were blood flow signals in the periphery； the bilateral ovaries were not found. The whole abdominal CT results showed there was a huge mixed-density mass in the pelvic cavity， with the lobed lobes and poorly defined boundaries； the size was about 132 mm×86 mm， and the CT value was about 33 HU. The enhancement scaning results showed obvious uneven enhancement of the lesion， obvious enhancement of the edge， and no obvious enhancement of the low-density shadow in the pelvic cavity； the multiple lymph node shadows with the diameter smaller than 6 mm were seen in the pelvic cavity， and the CT enhancement scaning results showed that the lymph nodes were slightly enhancement.The tumor markers had no significant abnormalities. The patient was diagnosis as pelvic mass and the probability of ovarian malignancy was high. After completing all the relevant examinations， the transabdominal bilateral salpingectomy and oophorectomy were performed after general anesthesia. The results of the pathological diagnosis after operation were ovarian DDLPS. No recurrence of the patient was found 10 months after operation. Conclusion The primary ovarian DDLPS is rare， and the clinical manifestations are not specific； imagological methods are helpful for the diagnosis； radical surgery is the main treatment method； targeted therapy can bring good efficacy for the patients； the disease has high malignancy， poor prognosis， and it is easy to relapse； so long-term follow-up should be performed.

Key words: Ovarian neoplasm, Primary, Dedifferentiated liposarcoma, Prognosis

中图分类号:

R737.31

李婧婧,热孜宛古丽·艾斯凯尔null,邢婉怡,邹颖刚. 单侧卵巢原发性去分化脂肪肉瘤1例报告及文献复习[J]. 吉林大学学报(医学版), 2023, 49(4): 1040-1045.

Jingjing LI, REZIWANGULI·Aisikaier,Wanyi XING,Yinggang ZOU. Primary dedifferentiated liposarcoma of unilateral ovary: A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2023, 49(4): 1040-1045.

图/表 3

参考文献 35

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