国际生殖健康/计划生育杂志

国际生殖健康/计划生育杂志 ›› 2025, Vol. 44 ›› Issue (6): 471-474.doi: 10.12280/gjszjk.20250296

• 病例报告 • 上一篇    下一篇

青少年卵巢纤维瘤伴CA125升高和Meigs综合征一例

王思瑶, 胡晓红, 令菲菲, 刘畅()   

  1. 730000 兰州大学第一临床医学院（王思瑶，胡晓红，令菲菲）；兰州大学第一医院妇产科，甘肃省妇科肿瘤重点实验室（刘畅）
  • 收稿日期:2025-06-06 出版日期:2025-11-15 发布日期:2025-11-18
  • 通讯作者: 刘畅，E-mail：lch@lzu.edu.cn

A Case of Elevated CA125 and Meigs Syndrome in An Adolescent Ovarian Fibroma

WANG Si-yao, HU Xiao-hong, LING Fei-fei, LIU Chang()   

  1. The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China (WANG Si-yao, HU Xiao-hong, LING Fei-fei); Department of Obstetrics and Gynecology, The First Hospital of Lanzhou University, Key Laboratory of Gynecological Tumor of Gansu Province, Lanzhou 730000, China (LIU Chang)
  • Received:2025-06-06 Published:2025-11-15 Online:2025-11-18
  • Contact: LIU Chang, E-mail: lch@lzu.edu.cn

RichHTML

0

PDF (PC)

9

摘要：

卵巢纤维瘤（ovarian fibroma）是一种常见的良性性索间质肿瘤，同时合并胸水、腹水且在切除后胸腹水消退为Meigs综合征。Meigs综合征发生率较低，伴随糖类抗原125（carbohydrate antigen 125，CA125）升高者易被误诊为恶性肿瘤。 本文报告1例18岁女性卵巢纤维瘤患者，因腹胀伴下腹膨隆就诊于外院，影像学提示盆腔巨大囊实性占位病变（11.3 cm×10.6 cm×7.9 cm）、大量盆腹腔积液、血清CA125显著升高（1 168.00 U/mL）。于兰州大学第一医院行患侧附件切除术，术中见多处粘连病灶，术后病理确诊为卵巢纤维瘤，肿瘤切除后患者出现胸闷气短，CT提示双侧胸腔积液，术后1个月胸腹水完全消退，CA125降至正常。术后随访2年未见复发及转移。因此，临床上盆腔肿物、CA125升高伴Meigs综合征，可能误诊为卵巢癌，本病例强调了在CA125升高的卵巢肿瘤的鉴别诊断中需考虑卵巢纤维瘤/卵泡膜纤维瘤的可能，手术切除是其首选的治疗方法，术后预后良好。

关键词: 卵巢肿瘤, 纤维瘤, 诊断, 治疗, 病例报告

Abstract:

Ovarian fibroma is a common benign sex cord stromal tumor, accompanied by pleural effusion and ascites, which regress to Meigs syndrome after resection. The incidence of Meigs syndrome is relatively low, and the ovarian fibroma with the elevated carbohydrate antigen 125 (CA125) is easily misdiagnosed as malignant tumor. We report a case of 18-year-old female patient with ovarian fibroma who was admitted to an external hospital due to abdominal distension and lower abdominal distension. Imaging showed a huge cystic solid mass in the pelvic cavity (11.3 cm × 10.6 cm × 7.9 cm), a large amount of pelvic and abdominal fluid accumulation, and a significant increase in serum CA125 (1 168.00 U/mL). The patient underwent adnexectomy on the affected side at the First Hospital of Lanzhou University. Multiple adhesive lesions were observed during the surgery, and the postoperative pathological diagnosis was ovarian fibroma. After tumor resection, the patient experienced chest tightness and shortness of breath, and CT showed bilateral pleural effusion. One month after surgery, the pleural and ascites completely subsided, and the level of CA125 returned to normal. Follow up for 2 year after surgery, the patient showed no recurrence or metastasis. Therefore, in clinical practice, pelvic masses with the elevated CA125 and Meigs syndrome may be misdiagnosed as ovarian cancer. This case emphasizes the possibility of ovarian fibroids/follicular membrane fibroids in the differential diagnosis of ovarian tumors with elevated CA125. Surgical resection is the preferred treatment method, and the postoperative prognosis is good.

Key words: Ovarian neoplasms, Fibroma, Diagnosis, Therapy, Case reports