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[假性梅格斯综合征,一种罕见变体]

[Pseudo-Meigs syndrome, a rare variant].

作者信息

Munteanu M, Petrescu F, Pleşea E, Stanciu Ecaterina, Enache S D, Munteanu M C, Munteanu A C, Pîrşcoveanu M, Stoica Zoia, Gugilă I

机构信息

Clinica III Chirurgie Generală, UMF Craiova.

出版信息

Chirurgia (Bucur). 2006 Mar-Apr;101(2):205-8.

Abstract

The pseudo- Meigs syndrome is defined as a pelvic tumour, other than the ovarian fibroma complicated with ascites and hydrothorax that can be recovered after the tumour is surgically extirpated. The uterine leiomyoma is an extremely rare cause of this syndrome, only 24 cases have been recorded so far, most of them presenting hydropic degeneration or necrosis. The case exposed by us, a 50- year old obese,with nanism woman, presented clinical, biological and imaging characteristics of the syndrome; moreover, she had arterial high blood pressure for more than five years, fact that didn't need postoperative treatment. She was sent to the ER because she had severe respiratory insufficiency, arterial high blood pressure, tachycardia and, at the clinical examination, she presented massive right hydrothorax, ascites, and pelvic tumour. The biologic explorations (the benign cytology in the pleural liquid and ascites, CA-125 with ten times the normal value) and the imagery completed the picture of a Meigs/ pseudo-Meigs syndrome that implied the laparotomy. The H-P examination and the postoperative evolution confirmed the diagnosis. We presented this case in order to emphasize both its rarity and its real positive and differential diagnosis problems.

摘要

假性梅格斯综合征定义为盆腔肿瘤(卵巢纤维瘤除外),伴有腹水和胸腔积液,肿瘤手术切除后可恢复。子宫平滑肌瘤是该综合征极为罕见的病因,迄今为止仅记录了24例,其中大多数表现为水样变性或坏死。我们报告的这例病例为一名50岁肥胖、身材矮小的女性,具有该综合征的临床、生物学和影像学特征;此外,她患有高血压超过五年,术后无需治疗。她因严重呼吸功能不全、动脉高血压、心动过速被送往急诊室,临床检查发现大量右侧胸腔积液、腹水和盆腔肿瘤。生物学检查(胸腔积液和腹水中良性细胞学检查,CA-125值为正常值的十倍)和影像学检查完善了梅格斯/假性梅格斯综合征的诊断,提示需行剖腹手术。组织病理学检查及术后病情演变证实了诊断。我们报告此病例是为了强调其罕见性以及实际的阳性诊断和鉴别诊断问题。

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