Sak Muhammet Erdal, Evsen Mehmet Siddik, Soydinc Hatice Ender, Sak Sibel, Yalinkaya Ahmet
Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey.
J Reprod Med. 2013 Jan-Feb;58(1-2):47-50.
To report the clinical characteristics of 14 patients with imperforate hymen and their levels of tumor markers (CA 19-9 and CA 125).
Fourteen patients with imperforate hymen who followed-up between September 2006 and September 2010 in the Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey, were evaluated retrospectively. The clinical features and the management of the patients are discussed.
The mean age of the patients was 13.8 years. All patients had primary amenorrhea and pelvic pain. The most common clinical symptoms were cryptomenorrhea in 14 patients, pelvic pain in 11, palpable abdominal mass in 6, voiding difficulties in 7, and defecation problems in 2. In 6 patients with palpable pelvic mass, the mean + standard deviation values of tumor markers were as follows: CA 125, 84.0 +/- 23.7 and CA 19-9, 162 +/- 189. One week after surgery we measured CA 125 and CA 19-9 levels once again. The postoperative mean CA 125 level was 13.8 +/- 3.6, and the mean postoperative CA 19-9 level was 17.5 +/- 3.5. Preoperative levels of CA 125 and CA 19-9 were significantly higher than those of the postoperative period (p < 0.001 for both comparisons). Six patients were treated by T-shaped incision and 8 patients by a central surgical incision through the hymenal membrane.
Diagnosis of imperforate hymen is very important before undergoing surgery in a different clinic. Many patients have seen several doctors before receiving a clear diagnosis and have had tumor markers evaluated because the presence of pelvic mass in patients suggests the possibility of a gynecologic malignancy. Imperforate hymen is one of the benign conditions that increase serum CA 125 and CA 19-9 levels and which is not listed in the classical medical textbooks. These markers are not needed for the diagnosis.
报告14例处女膜闭锁患者的临床特征及其肿瘤标志物（CA 19-9和CA 125）水平。
对2006年9月至2010年9月在土耳其迪亚巴克尔市迪克莱大学医学院妇产科随访的14例处女膜闭锁患者进行回顾性评估。讨论了患者的临床特征及治疗方法。
患者的平均年龄为13.8岁。所有患者均有原发性闭经和盆腔疼痛。最常见的临床症状为14例隐性闭经、11例盆腔疼痛、6例可触及腹部肿块、7例排尿困难和2例排便问题。在6例可触及盆腔肿块的患者中，肿瘤标志物的平均+标准差数值如下：CA 125为84.0±23.7，CA 19-9为162±189。手术后1周，我们再次测量了CA 125和CA 19-9水平。术后CA 125平均水平为13.8±3.6，术后CA 19-9平均水平为17.5±3.5。术前CA 125和CA 19-9水平显著高于术后水平（两项比较p均<0.001）。6例患者采用T形切口治疗，8例患者通过处女膜中央手术切口治疗。
在不同诊所进行手术前，处女膜闭锁的诊断非常重要。许多患者在得到明确诊断之前看过几位医生，并进行了肿瘤标志物评估，因为患者盆腔肿块的存在提示了妇科恶性肿瘤的可能性。处女膜闭锁是增加血清CA 125和CA 19-9水平的良性疾病之一，而经典医学教科书中未列出。这些标志物对诊断并非必需。
