广泛性腹膜平滑肌瘤病伴宫颈上腹腔镜子宫切除术后肿瘤内子宫内膜囊肿形成。
Leiomyomatosis peritonealis disseminata with formation of endometrial cysts within tumors arising after supracervical laparoscopic hysterectomy.
作者信息
Bogusiewicz Michał, Rosińska-Bogusiewicz Katarzyna, Walczyna Beata, Drop Andrzej, Rechberger Tomasz
机构信息
2nd Department of Gynaecology, Medica University of Lublin, Lublin, Poland.
出版信息
Ginekol Pol. 2013 Jan;84(1):68-71. doi: 10.17772/gp/1544.
BACKGROUND
Use of morcellation during laparoscopic hysterectomy may result in seeding of uterine tissue throughout the abdominal cavity and development of 'iatrogenic' leiomyomatosis peritonealis disseminata.
CASE
Two years after a supracervical laparoscopic hysterectomy a 42-year-old parous women presented with abdominal pain and bloating. CT scans and subsequent surgical exploration reveled multiple solid tumors containing cysts filled with altered blood. Histologically the tumors had characteristic features of a benign leiomyoma with smooth muscle cells infiltrated by endometrial glands.
CONCLUSION
Pieces of smooth muscle cell and endometrial uterine tissue lost in the abdominal cavity during morcellation may progress to leiomyomatosis peritonealis disseminata with unusual appearance.
背景
在腹腔镜子宫切除术中使用粉碎术可能导致子宫组织播散至整个腹腔，并引发“医源性”腹膜播散性平滑肌瘤病。
病例
一位42岁经产妇在次全腹腔镜子宫切除术后两年出现腹痛和腹胀。CT扫描及随后的手术探查发现多个实性肿瘤，其中含有充满血性液体的囊肿。组织学检查显示，肿瘤具有良性平滑肌瘤的特征，平滑肌细胞中有子宫内膜腺体浸润。
结论
粉碎术中腹腔内遗留的平滑肌细胞和子宫内膜组织碎片可能发展为外观异常的腹膜播散性平滑肌瘤病。
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