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诊断性腹腔镜检查发现一例伪装成卵巢癌的腹膜腺瘤样间皮瘤:病例报告

Diagnostic laparoscopy identifies a peritoneal adenomatoid-like mesothelioma masquerading as ovarian cancer: a case report.

作者信息

Okuda T, Ogino Y, Yamashita S, Ishii H, Kin S, Nagata A, Otsubo M, Kataoka H, Kitawaki J

出版信息

Eur J Gynaecol Oncol. 2014;35(1):91-4.

Abstract

The authors report a rare case of peritoneal adenomatoid mesothelioma in a woman with no history of asbestos exposure. A 61-year-old woman was originally suspected of having a bilateral ovarian tumor based on chest radiography and magnetic resonance imaging (MRI). Upon referral to our hospital, the presence of two solid masses was confirmed by enhanced MRI and 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG-PET/CT). Physical examination was normal, as were serum concentrations of the tumor markers CA 19-9, CA 125, and CEA. Laparoscopic surgery showed a right ovarian tumor and laparoscopic right salpingo-oophorectomy and adhesiotomy were performed. Two months later, the patient underwent laparoscopic segmental resection of the sigmoid colon, with histological analysis identifying an adenomatoid-like tumor. The final diagnosis was peritoneal adenomatoid-like mesothelioma with invasion of the right ovary. This case report demonstrates that imaging techniques must be coupled with laparoscopic surgery for an accurate diagnosis of peritoneal mesothelioma.

摘要

作者报告了一例无石棉接触史女性的腹膜腺瘤样间皮瘤罕见病例。一名61岁女性最初根据胸部X线摄影和磁共振成像(MRI)被怀疑患有双侧卵巢肿瘤。转诊至我院后,增强MRI和18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG-PET/CT)证实存在两个实性肿块。体格检查正常,肿瘤标志物CA 19-9、CA 125和CEA的血清浓度也正常。腹腔镜手术显示右侧卵巢肿瘤,并进行了腹腔镜右侧输卵管卵巢切除术和粘连松解术。两个月后,患者接受了乙状结肠腹腔镜节段性切除术,组织学分析发现一个腺瘤样肿瘤。最终诊断为腹膜腺瘤样间皮瘤伴右侧卵巢侵犯。本病例报告表明,成像技术必须与腹腔镜手术相结合,才能准确诊断腹膜间皮瘤。

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