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腹股沟管血管平滑肌瘤:腹股沟管内一种罕见疾病实体的病例报告。

Inguinal canal angioleiomyoma: case report of a rare disease entity within inguinal canal.

作者信息

Liu Jianwen, Wei Rockson, Yang Xuefei, Shen Xinping, Guan Jing, Fan Joe King Man

机构信息

Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.

Department of Surgery, The University of Hong Kong, Li Ka Shing Faculty of Medicine, Hong Kong, SAR, China.

出版信息

BMC Res Notes. 2017 Sep 6;10(1):452. doi: 10.1186/s13104-017-2800-9.

Abstract

BACKGROUND

Angioleiomyoma is an uncommon benign soft tissue tumor and originates from the vascular smooth muscle. It often causes pain and is rarely found in inguinal region. We present a rare case of inguinal canal angioleiomyoma of a female patient who suffered from right groin pain for 4 years and mimicking inguinal hernia clinically.

PRESENTATION OF CASE

A 53-year-old Chinese female patient presented with 4-year history of right groin pain which was exacerbated by movement. Magnetic resonance imaging was performed in view of atypical presentation and absence of cough impulse. Inguinal canal was subsequently explored by open approach and the mass was found arising from the posterior wall of the inguinal canal and measured 5.2 cm × 3.8 cm. The posterior wall was repaired by Bassini approach after the mass was resected en-bloc. Inguinal pain was resolved and no hernia was found during follow-up. Pathology of the resected specimen confirmed angioleiomyoma with clear resection margins.

CONCLUSION

This is the first report of a case of angioleiomyoma of the inguinal canal, which presents as a painful mass. Magnetic resonance imaging should be considered when presenting history and physical examination does not confirm with the diagnosis of inguinal hernia. After inguinal canal exploration, suture or mesh repair should be performed to prevent weakening of posterior wall leading to inguinal hernia.

摘要

背景

血管平滑肌瘤是一种罕见的良性软组织肿瘤,起源于血管平滑肌。它常引起疼痛,很少见于腹股沟区。我们报告一例罕见的女性腹股沟管血管平滑肌瘤病例,该患者右腹股沟疼痛4年,临床症状类似腹股沟疝。

病例介绍

一名53岁中国女性患者,有4年右腹股沟疼痛病史,活动时加重。鉴于临床表现不典型且无咳嗽冲击感,行磁共振成像检查。随后通过开放手术探查腹股沟管,发现肿块起源于腹股沟管后壁,大小为5.2 cm×3.8 cm。整块切除肿块后,采用巴西尼法修复后壁。腹股沟疼痛缓解,随访期间未发现疝。切除标本的病理检查证实为血管平滑肌瘤,切缘清晰。

结论

这是首例关于腹股沟管血管平滑肌瘤表现为疼痛性肿块的病例报告。当病史和体格检查不能确诊腹股沟疝时,应考虑磁共振成像检查。腹股沟管探查后,应进行缝合或补片修补,以防止后壁薄弱导致腹股沟疝。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b89/5588679/bfb2c5290caf/13104_2017_2800_Fig1_HTML.jpg

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