Chaudhry Shivani, Glanc Phyllis, Salem Shia
Department of Medical Imaging, University of Toronto, Toronto, Canada.
BMJ Case Rep. 2013 Aug 5;2013:bcr2012007744. doi: 10.1136/bcr-2012-007744.
Asymptomatic female in her early 30s presented for her singleton nuchal translucency ultrasound at 12.4 weeks of gestational age. No fetal abnormalities were seen. A large maternal left adnexal mass was identified, prompting a transvaginal ultrasound. The findings were felt to be consistent with an endometrioma, albeit with a 1 cm solid nodule. At this point, the diagnosis was considered to likely represent a decidualised endometrioma; however, warranting careful follow-up. The 20-week anatomy scan demonstrated an enlarging solid nodule that now contained vascularity within the left adnexal mass prompting an MRI. These features were more suggestive of malignancy, although a decidualised endometrioma, which can demonstrate intrapartum growth and vascularity, remained in the differential. Intrapartum sonographic surveillance documented progressive growth. The lesion was uneventfully removed at the time of delivery. Pathology showed clear cell carcinoma within an endometrioma.
一名30岁出头的无症状女性在孕12.4周时进行了单胎妊娠颈项透明层超声检查，未发现胎儿异常。发现一个较大的左侧附件区母体肿块，遂进行经阴道超声检查。检查结果被认为与子宫内膜瘤相符，尽管有一个1厘米的实性结节。此时，诊断被认为可能是蜕膜化子宫内膜瘤；不过，需要密切随访。孕20周的解剖扫描显示左侧附件区肿块内的实性结节增大，现在有血管，因此进行了磁共振成像（MRI）检查。这些特征更提示为恶性肿瘤，尽管蜕膜化子宫内膜瘤在分娩期也可出现生长和血管，仍需鉴别。分娩期超声监测记录到病变逐渐生长。分娩时病变顺利切除。病理显示子宫内膜瘤内为透明细胞癌。
