双侧妊娠黄体瘤一例诊治体会

doi:10.12280/gjszjk.20250058

摘要/Abstract

摘要：

妊娠黄体瘤（pregnancy luteoma，PL）是一种发病率极低、多发生于妊娠中晚期的卵巢瘤样病变，其病因和发病机制不清楚。PL临床表现差异较大、无特定影像学特征和特异的血清学标志物，加之临床医生对其认识不足，容易出现误诊误治。现报告1例双侧PL，患者出现高雄激素血症、胸腹水、血清甲胎蛋白（alpha-fetoprotein，AFP）和糖类抗原125（carbohydrate antigen 125，CA125）升高，影像学提示双侧卵巢较大肿瘤，不能排除卵巢恶性肿瘤的可能，建议手术治疗。患者拒绝手术，医疗组查阅相关文献后认为存在PL的可能性，因此采取保守治疗和密切的临床观察；随访1个月，症状消失，肝功能恢复正常，血清AFP和CA125正常，妇科彩色超声示子宫及双侧附件未及异常，排除了卵巢恶性肿瘤；继续随访22个月，无异常情况。该病例最终诊断为双侧卵巢PL，避免了手术，结局满意。

关键词: 妊娠, 黄体瘤, 卵巢肿瘤, 睾酮, CA-125抗原, 误诊

Abstract:

Pregnancy luteoma (PL) is an ovarian tumor-like lesion with very low incidence, which mostly occurs in the second and the third trimester. The etiology and pathogenesis of PL are unclear, and clinical manifestations vary greatly. There are no specific imaging features and serological markers. The misdiagnosis and mistreatment are prone to occur due to insufficient understanding and treatment experience. We report a case of PL, in which the patient presented with hyperandrogenism, hydrothorax and ascites, and elevated serum alpha-fetoprotein (AFP) and carbohydrate antigen 125 (CA125). Imaging suggested bilateral large ovarian masses. The possibility of malignant ovarian tumor cannot be ruled out, and surgical treatment was recommended. The patient refused to undergo surgery. After reviewing relevant literatures, we realized the possibility of PL. Conservative treatment and clinical observation were adopted. After a one-month follow-up, the symptoms disappeared, liver function returned to normal, and serum AFP and CA125 normal. Gynecological color ultrasound showed no abnormalities in the uterus and bilateral adnexa, ruling out ovarian malignancy. The follow-up was continued for 22 months with no abnormal conditions, and clinical outcome was satisfactory. Eventually, the bilateral PL was diagnosed, and the surgery as for this case was successfully avoided.

Key words: Pregnancy, Luteoma, Ovarian neoplasms, Testosterone, CA-125 antigen, Diagnostic errors

陈建超, 王华, 董渠龙. 双侧妊娠黄体瘤一例诊治体会[J]. 国际生殖健康/计划生育杂志, 2025, 44(4): 307-311.

CHEN Jian-chao, WANG Hua, DONG Qu-long. Diagnosis and Treatment of Bilateral Pregnancy Luteoma: A Case Report[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(4): 307-311.

图/表 3

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