Leung See Wai, Yuen Pong Mo
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
Gynecol Obstet Invest. 2006;62(1):1-6. doi: 10.1159/000091679. Epub 2006 Feb 22.
We review clinical characteristics, diagnostic difficulties, and our experience in the surgical management of ovarian fibromas.
Twenty-three women with the operative diagnosis of an ovarian fibroma managed between January 1995 and August 2004 were reviewed retrospectively.
These patients comprised 1% of all benign ovarian tumors seen over this study period. The median age was 45 years, and 11 patients (47.8%) were postmenopausal. The main presenting symptom was abdominal pain (43.5%). The diagnosis of an ovarian fibroma or a solid ovarian tumor was correctly made preoperatively in only 5 patients (21.7%). All patients underwent surgical treatment: 18 by laparotomy and 5 by laparoscopy. All tumors were unilateral, and the median size was 13 cm. Fourteen patients underwent conservative surgery, and 9 had total abdominal hysterectomy with bilateral salpingo-oophorectomy. Two cases of fibrosarcoma were reviewed on the final pathology.
Gynecologists should be aware of this group of ovarian tumors despite their uncommon occurrence. There are clinical clues to differentiate an ovarian fibroma from uterine fibroid and ovarian malignancy. Surgical removal of these solid ovarian tumors is recommended because of the low probability of malignancy. Minimal-access surgery is an option, especially when the tumor is of moderate or small size.
我们回顾卵巢纤维瘤的临床特征、诊断难点以及我们在其外科治疗方面的经验。
回顾性分析1995年1月至2004年8月间手术诊断为卵巢纤维瘤的23例女性患者。
在本研究期间，这些患者占所有良性卵巢肿瘤的1%。中位年龄为45岁，11例患者（47.8%）已绝经。主要症状为腹痛（43.5%）。术前仅5例患者（21.7%）正确诊断为卵巢纤维瘤或实性卵巢肿瘤。所有患者均接受了手术治疗：18例行剖腹手术，5例行腹腔镜手术。所有肿瘤均为单侧，中位大小为13cm。14例患者接受了保守手术，9例患者接受了全腹子宫切除术及双侧输卵管卵巢切除术。最终病理检查发现2例纤维肉瘤。
尽管卵巢纤维瘤发病率不高，但妇科医生仍应了解这类卵巢肿瘤。有临床线索可将卵巢纤维瘤与子宫肌瘤及卵巢恶性肿瘤相鉴别。鉴于恶性概率较低，建议手术切除这些实性卵巢肿瘤。微创手术是一种选择，尤其是当肿瘤为中、小尺寸时。
