Ruan C W, Lee C L, Yen C F, Wang C J, Soong Y K
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, R.O.C.
Changgeng Yi Xue Za Zhi. 1999 Dec;22(4):639-42.
Surgery for massive abdominal tumors is both interesting and challenging. We present a case involving a multiple uterine myoma weighing 6.2 Kg which coincided with omental leiomyosarcoma. To our knowledge, this is the first report of this type of condition in the English literature. A 44-year-old nulliparous woman had suffered from abdominal pain for a long time. A huge abdominal mass was palpated on physical examination. Computed tomography scanning revealed a huge pelvic-abdominal mass with the possibility of small bowel loops invaded by the mass. A 6-cm omental mass was incidentally found during the subsequent hysterectomy procedure. Perforation of the urinary bladder occurred during the dissection of adhesion. Resection of the omental mass, wide wedge resection of the invaded small bowel, primary repair of the bladder, and hysterectomy were performed. The final pathologic diagnosis was uterine leiomyomata with omental leiomyosarcoma. The patient returned home on postoperative day 14 and was well at the 18-month follow-up examination. The challenge of these tumors lies in their proper diagnosis and surgical management. More case reports and follow-up studies are needed to confirm the efficacy of their management.
巨大腹部肿瘤的手术既有趣又具有挑战性。我们报告一例涉及重达6.2千克的多发性子宫肌瘤并伴有网膜平滑肌肉瘤的病例。据我们所知，这是英文文献中关于此类病症的首例报告。一名44岁未生育的女性长期遭受腹痛。体格检查时触诊到一个巨大的腹部肿块。计算机断层扫描显示盆腔 - 腹部有一个巨大肿块，肿块可能侵犯了小肠袢。在随后的子宫切除术中偶然发现一个6厘米的网膜肿块。在粘连分离过程中膀胱发生穿孔。进行了网膜肿块切除、受侵犯小肠的广泛楔形切除、膀胱一期修复和子宫切除术。最终病理诊断为子宫平滑肌瘤伴网膜平滑肌肉瘤。患者术后第14天出院，18个月随访检查时情况良好。这些肿瘤的挑战在于其正确诊断和手术管理。需要更多的病例报告和随访研究来证实其治疗效果。
