摘要
目的总结低级别子宫内膜间质肉瘤的临床特点、误诊原因及预防措施。方法对3例被误诊的低级别子宫内膜间质肉瘤的临床资料进行回顾性分析。结果3例年龄均在40~50岁,1例表现为异常阴道出血,另2例无明显自觉症状。术前均误诊为子宫肌瘤,行腹腔镜下肌瘤剔除术。术后病理检查证实为低级别子宫内膜间质肉瘤,均再次手术行全子宫、双附件切除,其中2例同时行大网膜切除,术后2例补充腹腔热灌注化疗,随访至今无复发。结论子宫内膜间质肉瘤临床少见,误诊率较高。临床医师应提高警惕,谨慎实施腹腔镜下碎瘤术,误诊发生后采取积极措施减少患者复发。
Objective To summarize the clinical characteristics,misdiagnosed causes and preventive measures of low-grade endometrial stromal sarcoma(LG-ESS).Methods Clinical data of 3 patients with LG-ESS misdiagnosed as having other diseases was retrospectively analyzed.Results The 3 patients were aged between 40-50 years,of whom included 1 with abnormal vaginal hemorrhage,and the other 2 with no obvious symptoms.All patients were misdiagnosed as having leiomyoma before surgery,and underwent laparoscopic myomectomy.All of them were diagnosed as LG-ESS by pathological examination after surgery and underwent total hysterectomy and bilateral adnexectomy,including 2 cases with greater omentectomy,and then they were supplemented with hyperthermic perioperative chemotherapy(HIPEC).There has been no recurrence after follow-up to date.Conclusion LG-ESS is rare in clinical practice and therefore it is more likely to be misdiagnosed.Clinicians should improve vigilance of the disease,and perform laparoscopic resection and morcellation with caution.In case of a misdiagnosis,active remedial measures should be adopted to reduce the recurrence rate.
作者
刘晓华
吴庆蓉
续云芳
LIU Xiao-hua;WU Qing-rong;XU Yun-fang(Department of Gynecology,Fuling Central Hospital,Chongqing 408000,China)
出处
《临床误诊误治》
CAS
2021年第4期15-18,共4页
Clinical Misdiagnosis & Mistherapy
关键词
肉瘤
子宫内膜间质
误诊
肌瘤
子宫
腹腔镜
Sarcoma,endometrial stromal
Misdiagnosis
Fibroids,uterine
Laparoscopes
