Nassif Joseph, Nahouli Hasan, Mourad Ali, Yammine Ryan, Khoury Sally, Khalil Ali
Obstetrics and Gynecology Department, American University of Beirut Medical Center, Beirut, Lebanon.
Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Surg Technol Int. 2017 Dec 22;31:140-143.
Nabothian cysts are mucinous retention cysts formed through the accumulation of cervical mucus inside blocked cervical crypts leading to non-neoplastic mucinous cystic lesion in relation to the uterine cervix. The formation of Nabothian cysts is a common gynecological benign condition in women of reproductive age. While the presence of small-sized Nabothian cysts is usually clinically asymptomatic and requires no treatment or intervention, the diagnosis of larger Nabothian cysts can be mistaken with malignant tumors, including mucin producing carcinomas such as Adenoma malignum. In this study, we report the case of a large Nabothian cyst that was correctly diagnosed preoperatively using ultrasonography and magnetic resonance imaging (MRI), and successfully treated through laparoscopic excision, avoiding the performance of unnecessary hysterectomy. A 44-year old Lebanese patient presented with chronic dyspareunia and pelvic pain. An ultrasound was performed and revealed an 8cm multiloculated anechoic pelvic cystic lesion with no solid components. An MRI was performed and showed an 8cm mass lateral to the right vaginal wall, suggestive of a Nabothian cyst. The patient was scheduled for laparoscopic removal of the Nabothian cyst. The patient tolerated the procedure well and was discharged under stable condition a few hours after the operation. Careful preoperative examination, including the use of imaging methods such as ultrasonogoraphy and MRI, is crucial for diagnosis and differentiation of atypical presentation of benign, but large and complex, Nabothian cysts from other differential conditions of malignancies, consequently avoiding unnecessary hysterectomy. Use of laparoscopy as a minimally-invasive technique to excise such cysts is considered a valid option, allowing for a fast recovery for the patients.
纳博特囊肿是黏液性潴留囊肿，由宫颈黏液在阻塞的宫颈隐窝内积聚形成，导致子宫颈出现非肿瘤性黏液性囊性病变。纳博特囊肿的形成是育龄期女性常见的妇科良性病症。虽然小型纳博特囊肿通常临床上无症状，无需治疗或干预，但较大的纳博特囊肿诊断可能会与恶性肿瘤混淆，包括产黏液癌，如恶性腺瘤。在本研究中，我们报告了一例大型纳博特囊肿病例，术前通过超声检查和磁共振成像（MRI）正确诊断，并通过腹腔镜切除成功治疗，避免了不必要的子宫切除术。一名44岁的黎巴嫩患者出现慢性性交困难和盆腔疼痛。进行超声检查发现一个8厘米的多房无回声盆腔囊性病变，无实性成分。进行MRI检查显示右侧阴道壁外侧有一个8厘米的肿块，提示为纳博特囊肿。患者被安排进行腹腔镜下纳博特囊肿切除术。患者手术耐受性良好，术后数小时在病情稳定的情况下出院。仔细的术前检查，包括使用超声检查和MRI等影像学方法，对于诊断和鉴别良性但大型且复杂的纳博特囊肿的非典型表现与其他恶性鉴别情况至关重要，从而避免不必要的子宫切除术。使用腹腔镜作为切除此类囊肿的微创技术被认为是一种有效的选择，可使患者快速康复。
