宫颈脂肪平滑肌瘤17例临床分析

doi:10.12280/gjszjk.20240171

摘要/Abstract

摘要：

目的： 提高对宫颈脂肪平滑肌瘤（cervical lipoleiomyoma）的认识及治疗水平。方法： 回顾性分析2011年9月—2023年4月首都医科大学附属北京妇产医院（我院）收治的17例经手术、病理确诊的宫颈脂肪平滑肌瘤患者的病例资料，分析其发病机制、临床表现、诊断与鉴别诊断及治疗。结果： 我院17例患者平均发病年龄为（44.6±9.6）岁。患者主要表现为下腹痛或腰痛、月经量增多或无明显临床症状。全部患者行超声检查，均未提示宫颈脂肪平滑肌瘤，5例（29.4%）患者提示肌瘤变性。6例患者行盆腔磁共振成像检查，2例患者检出脂肪成分。17例患者均行手术治疗，术中见宫颈肌瘤结节，直径2.0~15.0 cm不等，术后均经病理证实为宫颈脂肪平滑肌瘤。随访3~141个月，仅1例患者术后9个月再次发现宫颈肿物，行根治性手术，术后病理证实为宫颈平滑肌瘤。结论： 宫颈脂肪平滑肌瘤的发生较为罕见，缺乏特异性临床症状和影像学表现，诊断主要依靠手术探查和术后病理，治疗方法主要是手术治疗，并需要术后长期随访。

关键词: 子宫颈, 宫颈肿瘤, 平滑肌瘤, 脂肪瘤, 诊断, 治疗, 宫颈脂肪平滑肌瘤

Abstract:

Objective: To improve the diagnosis and treatment of cervical lipoleiomyoma. Methods: 17 cases of cervical lipoleiomyoma admitted between September 2011 and April 2023 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University were analyzed retrospectively, including their pathogenesis, clinical characteristics, diagnosis and differential diagnosis, and treatment. Results: The average age of onset was (44.6±9.6) years. Patients mainly presented with lower abdominal pain or flank pain, menorrhagia, or asymptomatic. Ultrasound examination in all patients did not suggest cervical lipoleiomyoma, while 5 patients (29.4%) were suggested the degeneration of the myoma. Six patients underwent magnetic resonance imaging (MRI), and 2 cases detected fatty component. All 17 patients underwent surgical treatment. The cervical lipoleiomyoma ranged from 2.0 to 15.0 cm in diameter. Postoperative pathology of all cases showed cervical lipoleiomyoma. Follow-up ranged from 3 to 141 months, and only one patient had a cervical mass rediscovered at 9 months postoperatively and underwent radical surgery. Conclusions: Cervical lipoleiomyoma is a rare benign tumor, lacking specific clinical symptoms and imaging. The diagnosis mainly depends on surgical exploration and postoperative pathology, and surgery is the main treatment. Long-term follow-up after operation is required.

Key words: Cervix uteri, Uterine cervical neoplasms, Leiomyoma, Lipoma, Diagnosis, Therapy, Cervical lipoleiomyoma

许阡, 成九梅. 宫颈脂肪平滑肌瘤17例临床分析[J]. 国际生殖健康/计划生育杂志, 2024, 43(5): 390-394.

XU Qian, CHENG Jiu-mei. Clinical Analysis of 17 Cases of Cervical Lipoleiomyoma[J]. Journal of International Reproductive Health/Family Planning, 2024, 43(5): 390-394.

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