18例静脉内平滑肌瘤病临床病理分析

发布时间：2018-04-12 19:52

本文选题：静脉内平滑肌瘤病 + 平滑肌瘤　；参考：《中国妇产科临床杂志》2017年02期

【摘要】：目的探讨静脉内平滑肌瘤病的临床病理特点和治疗策略。方法回顾性分析北京大学人民医院收治的18例静脉内平滑肌瘤病患者临床病理资料。结果 18例患者中,12例就诊于妇科,6例就诊于血管外科;中位数年龄为45岁,主诉以月经改变、腹痛及运动后黑朦为主。术前影像学检查如彩色超声、MRI、CT、血管造影等检查可初步提示该疾病,8例术前提示此诊断。18例患者均接受手术治疗,在血管外科就诊的患者中2例行盆腔肿物切除术,4例行下腔静脉(心房)病变切除术,妇科手术范围包括7例行全子宫双侧输卵管卵巢切除术,7例行全子宫切除术,2例既往曾行全子宫切除术的患者,术中切除子宫外病灶后切除双侧输卵管卵巢,1例行子宫肌瘤切除术。术中均尽可能切除肿瘤组织,术后经病理明确诊断。术后均未药物治疗,平均随访34.7个月,一例患者术后1年复发,再次手术切除复发病灶并切除双侧输卵管卵巢后随访无复发。结论静脉内平滑肌瘤病术前诊断较困难,影像学检查有辅助诊断价值。手术为主要治疗方式,无生育要求者建议切除全子宫及双侧附件。
[Abstract]:Objective to investigate the clinicopathological features and treatment of venous leiomyomatosis.Methods the clinicopathological data of 18 patients with venous leiomyomatosis treated in the people's Hospital of Peking University were analyzed retrospectively.Results among the 18 patients, 12 cases were diagnosed in gynecological gynecology and 6 cases in vascular surgery. The median age was 45 years old. The main complaints were menstrual change, abdominal pain and amaurosis after exercise.Preoperative imaging examination, such as color ultrasound MRI CT, angiography and so on, could preliminarily suggest that 8 patients with this disease should be diagnosed before operation. All 18 patients received surgical treatment.Two patients underwent pelvic mass resection and 4 patients underwent resection of inferior vena cava (atrial) lesions.The scope of gynecological surgery included 7 cases of total bilateral oviductal oviectomy and 7 cases of total hysterectomy.Hysterectomy was performed in 1 patient with bilateral oviduct and ovary after excision of extrauterine lesions.Tumor tissue was excised as much as possible during the operation, and the pathological diagnosis was confirmed after operation.All patients were followed up for an average of 34.7 months. One patient recurred 1 year after operation and had no recurrence after resection of the recurrent lesions and bilateral oviducts.Conclusion the preoperative diagnosis of venous leiomyomatosis is difficult.Surgery is the main method of treatment. Those who are not required to have children are advised to remove the whole uterus and bilateral appendages.
【作者单位】：北京大学人民医院妇产科;北京大兴区人民医院妇产科;北京大学人民医院病理科;
【分类号】：R732.22

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