Obstetrics and Gynecology Research Institute, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Am J Med Sci. 2011 Mar;341(3):181-4. doi: 10.1097/MAJ.0b013e3181f99ca4.
To describe and analyze the clinicopathologic characteristics of ovarian malignancies discovered at cesarean section (CS).
A retrospective study based on clinical histories from 13 patients diagnosed concurrently with CS at our hospital from January 1991 to December 2008.
The incidence of ovarian malignancies diagnosed during CS was 0.21 in 1000 CS. Histopathologic categories included malignant germ cell tumor (2, 15.38%), invasive epithelial carcinoma (3, 23.08%) and low-malignant potential tumor (8, 61.54%). All patients were clinically asymptomatic and diagnosed in stage I. Ovarian masses were detected by ultrasound in only 5 patients before surgery, but no malignancy was indicated. Tumor sizes ranged from 2.5 to 30 cm. Six malignancies were diagnosed by paraffin section after surgery, and of these, 2 patients received second surgery for tumor staging. Conservative surgical treatment was performed on 12 patients. Three patients received adjuvant chemotherapy. All patients are currently in complete remission. No maternal and fetal complication related to surgery was observed.
Ultrasound in the first trimester is recommended to rule out the adnexal mass. Frozen section is indicated for any suspicion. Conservative therapy could be applied to most patients with good prognosis if the patient was chosen carefully.
描述并分析在剖宫产时发现的卵巢恶性肿瘤的临床病理特征。
回顾性研究，基于我院 1991 年 1 月至 2008 年 12 月同时行剖宫产术的 13 例患者的临床病史。
剖宫产时诊断出卵巢恶性肿瘤的发生率为 1000 例剖宫产中 0.21 例。组织病理学分类包括恶性生殖细胞肿瘤（2 例，15.38%）、侵袭性上皮癌（3 例，23.08%）和低恶性潜能肿瘤（8 例，61.54%）。所有患者均无临床症状，且均处于 I 期。仅 5 例患者在术前通过超声检查发现卵巢肿块，但未提示恶性肿瘤。肿瘤大小从 2.5 厘米至 30 厘米不等。6 例恶性肿瘤通过术后石蜡切片诊断，其中 2 例患者接受了肿瘤分期的二次手术。12 例患者接受了保守性手术治疗。3 例患者接受了辅助化疗。所有患者目前均完全缓解。未观察到与手术相关的母婴并发症。
建议在孕早期进行超声检查以排除附件肿块。如果有任何怀疑，应进行冰冻切片检查。如果仔细选择患者，大多数患者可采用保守疗法，预后良好。
