Phupong Vorapong, Sueblinvong Thanasak, Triratanachat Surang
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, 10330 Pathumwan, Bangkok, Thailand.
Arch Gynecol Obstet. 2004 Nov;270(3):189-91. doi: 10.1007/s00404-003-0479-8. Epub 2003 Feb 14.
Benign cystic teratomas are one of the most common benign ovarian neoplasms. Although its rupture is rare, once occurred it can cause complications such as granulomatous peritonitis, mimicking metastatic ovarian malignancy.
A 39-year-old woman, Para 0-0-0-0, presented to the hospital with rapid abdominal distention for 3 months. Her physical examination and ultrasonographic findings led to a diagnosis of advanced stage ovarian carcinoma. An exploratory laparotomy was performed and the operative impression was that of stage III ovarian carcinoma. Total hysterectomy with bilateral salpingo-oophorectomy and surgical staging were done. The postoperative pathology revealed a benign cystic teratoma of right ovary with chronic granulomatous peritonitis. She was well at discharge and at her 1-year follow-up.
Although ruptured a benign cystic teratoma is rare, it can cause granulomatous peritonitis, the clinical findings of which mimic advanced stage ovarian carcinoma. This warrants physicians to be aware of and intraoperative frozen section should be used, its correct management will provide a good outcome with less complication.
良性囊性畸胎瘤是最常见的卵巢良性肿瘤之一。虽然其破裂罕见，但一旦发生可导致诸如肉芽肿性腹膜炎等并发症，酷似转移性卵巢恶性肿瘤。
一名39岁未育女性因3个月内腹部迅速膨隆入院。体格检查及超声检查结果提示晚期卵巢癌诊断。遂行剖腹探查术，术中印象为Ⅲ期卵巢癌。行全子宫双附件切除术及手术分期。术后病理显示右卵巢良性囊性畸胎瘤伴慢性肉芽肿性腹膜炎。出院时及1年随访时情况良好。
尽管良性囊性畸胎瘤破裂罕见，但可导致肉芽肿性腹膜炎，其临床表现酷似晚期卵巢癌。这就要求医生予以重视，术中应行冰冻切片检查，正确的处理可减少并发症并取得良好预后。
