卵巢静脉血管平滑肌肉瘤一例并文献复习

doi:10.12280/gjszjk.20220313

摘要/Abstract

摘要：

报告1例较罕见的卵巢静脉血管平滑肌肉瘤的病例。该患者为34岁年轻女性，临床主要表现为发现盆腔肿物3年，左下腹不适伴月经周期延长1个月余，血清肿瘤标志物升高不明显，磁共振成像示盆腔左侧髂血管旁类圆形异常信号占位影。该患者于2022年4月28日在气管插管全身麻醉下行腹腔镜下盆腔肿物切除术+右侧卵巢囊肿剥除术+盆腔粘连松解术，术后给予多柔比星脂质体化疗，现密切随访中。分析该病例资料，并复习国内外报道的12例卵巢静脉血管平滑肌肉瘤的病例资料，以期提高对该病的认识。

关键词: 卵巢, 平滑肌肉瘤, 静脉, 诊断, 治疗, 预后

Abstract:

A case of ovarian venous angioleiomyosarcoma is reported. The patient was a 34-year-old young woman. The main clinical manifestations were the discovery of pelvic mass for 3 years, left lower quadrant discomfort and prolonged menstrual cycle for more than 1 month. The increases of the serum tumor markers were not obvious. The magnetic resonance imaging showed the abnormal signal mass beside the left iliac blood vessels in the left pelvis. The patient underwent laparoscopic pelvic tumor resection, right ovarian cyst excision and pelvic adhesion release under general anesthesia with tracheal intubation on April 28, 2022. The doxorubicin liposome chemotherapy was given after surgery, and the patient was followed up closely. To analyze the clinical data of this case, and to review the reported data of 12 cases will be helpful for us to improve the understanding of ovarian venous angioleiomyosarcoma.

Key words: Ovary, Leiomyosarcoma, Veins, Diagnosis, Therapy, Prognosis

李玉兰, 要慧萍, 杨盼盼, 肖晨朦, 马雪影, 刘晓, 许飞雪. 卵巢静脉血管平滑肌肉瘤一例并文献复习[J]. 国际生殖健康/计划生育, 2022, 41(6): 468-471.

LI Yu-lan, YAO Hui-ping, YANG Pan-pan, XIAO Chen-meng, MA Xue-ying, LIU Xiao, XU Fei-xue. Ovarian Venous Angioleiomyosarcoma: A Case Report and Literature Review[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(6): 468-471.

图/表 5

参考文献 20

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作者	年龄（岁）	症状	位置	病理标本大小（cm）	治疗	辅助治疗	随访结果
López-Ruiz等^[1]	67	腹部不适	左侧	18×12×8	全子宫切除术+双侧附件切除术	阿霉素静脉化疗	术后17个月出现远处播散性转移
Honoré等^[2]	54	胆绞痛	右侧	4×3×3	单纯肿物切除术	外照射治疗+二次手术（清扫淋巴结）	未随访
Kawai等^[3]	61	间歇性左下腹疼痛	左侧	5.5×3×2	单纯肿物切除术	口服依托泊苷化疗	术后44个月无复发及转移
Saigusa等^[4]	78	纳差、左腹部肿物	左侧	未记录	单纯肿物切除术	未行辅助治疗	术后5个月无复发
Cho等^[5]	39	右上腹肿物	右侧	未记录	切除肿物、右肾、右侧输尿管和腹膜后组织	放疗	术后3个月出现肝脏转移
Iannelli等^[6]	50	右下腹包块	右侧	未记录	根治性肿物切除术	放疗	未随访
Chiarugi等^[7]	70	右下腹和侧腹部疼痛	右侧	7.5×3.7 ×3.5	完全切除肿物	未行辅助治疗	未随访
Tsuchiya等^[8]	54	背痛	右侧	未记录	右肾切除术、下腔静脉切除术和下腔静脉补片重建的肿瘤切除术	未行辅助治疗	术后14个月仍存活
Kim等^[9]	58	右下腹包块	右侧	未记录	腹膜后肿块切除术	未行辅助治疗	术后2个月无症状
Tsuyoshi等^[10]	49	左下腹包块	左侧	未记录	子宫和双侧附件及左侧卵巢静脉切除	吉西他滨和多西紫杉醇辅助化疗	术后22个月无复发及转移
Yang等^[11]	52	右侧腰痛	右侧	未记录	未行手术治疗	未行辅助治疗	未随访
王超等^[12]	64	腹胀、尿频伴左下腹坠痛	左侧	11.5×5.5 ×3.6	单纯肿物切除术	未行辅助治疗	未随访

作者	年龄（岁）	症状	位置	病理标本大小（cm）	治疗	辅助治疗	随访结果
López-Ruiz等^[1]	67	腹部不适	左侧	18×12×8	全子宫切除术+双侧附件切除术	阿霉素静脉化疗	术后17个月出现远处播散性转移
Honoré等^[2]	54	胆绞痛	右侧	4×3×3	单纯肿物切除术	外照射治疗+二次手术（清扫淋巴结）	未随访
Kawai等^[3]	61	间歇性左下腹疼痛	左侧	5.5×3×2	单纯肿物切除术	口服依托泊苷化疗	术后44个月无复发及转移
Saigusa等^[4]	78	纳差、左腹部肿物	左侧	未记录	单纯肿物切除术	未行辅助治疗	术后5个月无复发
Cho等^[5]	39	右上腹肿物	右侧	未记录	切除肿物、右肾、右侧输尿管和腹膜后组织	放疗	术后3个月出现肝脏转移
Iannelli等^[6]	50	右下腹包块	右侧	未记录	根治性肿物切除术	放疗	未随访
Chiarugi等^[7]	70	右下腹和侧腹部疼痛	右侧	7.5×3.7 ×3.5	完全切除肿物	未行辅助治疗	未随访
Tsuchiya等^[8]	54	背痛	右侧	未记录	右肾切除术、下腔静脉切除术和下腔静脉补片重建的肿瘤切除术	未行辅助治疗	术后14个月仍存活
Kim等^[9]	58	右下腹包块	右侧	未记录	腹膜后肿块切除术	未行辅助治疗	术后2个月无症状
Tsuyoshi等^[10]	49	左下腹包块	左侧	未记录	子宫和双侧附件及左侧卵巢静脉切除	吉西他滨和多西紫杉醇辅助化疗	术后22个月无复发及转移
Yang等^[11]	52	右侧腰痛	右侧	未记录	未行手术治疗	未行辅助治疗	未随访
王超等^[12]	64	腹胀、尿频伴左下腹坠痛	左侧	11.5×5.5 ×3.6	单纯肿物切除术	未行辅助治疗	未随访