国际生殖健康/计划生育杂志 ›› 2023, Vol. 42 ›› Issue (4): 291-295.doi: 10.12280/gjszjk.20220563

• 病例报告 • 上一篇    下一篇

巨大子宫脂肪平滑肌瘤伴脂肪瘤家族史一例并文献复习

许阡, 王欣()   

  1. 100006 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
  • 收稿日期:2022-12-02 出版日期:2023-07-15 发布日期:2023-07-26
  • 通讯作者: 王欣 E-mail:wangxin@ccmu.edu.cn

Giant Uterine Lipoleiomyoma with Lipoma Family History: A Case Report and Literature Review

XU Qian, WANG Xin()   

  1. Gynecology Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100006, China
  • Received:2022-12-02 Published:2023-07-15 Online:2023-07-26
  • Contact: WANG Xin E-mail:wangxin@ccmu.edu.cn

摘要:

报告1例有脂肪瘤家族史的53岁巨大子宫脂肪平滑肌瘤病例。该患者子宫肌瘤进行性增大7年,行盆腔磁共振成像考虑巨大子宫脂肪平滑肌瘤可能,拟手术治疗入院。追溯患者家族史,其祖母及父亲均患有多发脂肪瘤。本次入院后行开腹全子宫切除术+双附件切除术,术中探查见子宫前壁下段至宫颈实性肿物大小18 cm×12 cm×12 cm,剖检可见子宫下段肿物剖面呈淡黄色,脂肪样改变,质中有弹性,伴油腻感,其内见白色隔膜将肿物分为两部分,术后病理提示子宫脂肪平滑肌瘤。子宫脂肪平滑肌瘤发病率较低,多数患者无症状或症状不典型,临床易误诊。雌激素缺乏和代谢紊乱是其发病的危险因素,对于合并代谢紊乱的绝经后女性,需尤其引起重视,警惕该病的发生。子宫脂肪平滑肌瘤目前尚无规范化的治疗方案,无症状患者可保守治疗,有症状患者多行手术治疗,手术方案需根据患者的情况综合考虑。其虽为良性肿瘤,但有恶变风险及合并妇科恶性肿瘤的可能,需密切随访。

关键词: 子宫肿瘤, 子宫, 平滑肌瘤, 脂肪瘤, 病例报告

Abstract:

To report a case of a 53-year-old woman who had giant uterine lipoleiomyoma and family history of lipoma. This patient had progressively enlarged uterine fibroids for 7 years. The pelvic examination of magnetic resonance imaging suggested the possibility of a giant uterine lipoleiomyoma. Tracing the family history, both her grandmother and father had multiple lipomas. After admission, the total hysterectomy and double adnexectomy was performed. During the operation, the size of solid tumors from the lower segment of the anterior wall of the uterus to the cervix was 18 cm×12 cm×12 cm, the cut surface of tumor was light yellow, with the fatlike changes, elasticity in the texture, and greasy feeling. The white diaphragm was found to divide the tumor into two parts. Postoperative pathology showed the uterine lipoleiomyoma. The incidence of uterine lipoleiomyoma is low, and most patients are asymptomatic or have atypical symptoms, making them easy to misdiagnose. Estrogen deficiency and metabolic disorders are risk factors for its development. The post -menopausal women with the combined metabolic disorders need to be particularly alert to the development of this disease. There are no standardized treatments. Those asymptomatic patients can be treated conservatively, while symptomatic patients are often treated surgically, with the surgical option being considered on a case-by-case basis. Although it is a benign tumor, it has a risk of malignant transformation and probability of combining with gynecological malignancies, it is necessary to have the close follow-up after operation.

Key words: Uterine neoplasms, Uterus, Leiomyoma, Lipoma, Case reports