Ma Liang, Zhang Liwen, Zhuang Yun, Ding Yanbo, Chen Jianping
Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University Department of Pediatrics, the Second People's Hospital of Changzhou, Affiliate Hospital of NanJing medical University, Changzhou, Jiangsu, China.
Medicine (Baltimore). 2018 Jun;97(25):e10916. doi: 10.1097/MD.0000000000010916.
Massive ascites as the first sign of ovarian juvenile granulosa cell tumor (JGCT) in an adolescent is an extremely rare, and its clinical features and treatment methods have not been well described.
The clinical characteristics, diagnosis, and treatment methods in a 19-year-old girl who presented with massive abdominal distention and ascites was retrospectively reviewed. Abdominopelvic ultrasonography showed a large amount of ascites. The nature of ascites was exudate. All tumor markers were normal, but ascites and serum tumor CA125 levels were significantly increased. Abdominal CT showed left attachment area teratoma and right attachment area capsule solid change.
Histological and immunohistochemical results were compatible with JGCT. Based on the FIGO classification, the patient with only malignant ascites was categorized into stage IC.
The patient underwent mass resection with salpingoophorectomy. Following the operation, she received 6 courses of adjuvant chemotherapy with Nedaplatin and Paclitaxel liposome.
The patient was followed up postoperatively for 6 months to date without recurrence.
We should be highly vigilant the JGCT with massive ascites as the first clinical manifestation.
青少年卵巢幼年型颗粒细胞瘤(JGCT)以大量腹水为首发症状极为罕见,其临床特征及治疗方法尚未得到充分描述。
回顾性分析一名19岁出现大量腹胀和腹水女孩的临床特征、诊断及治疗方法。腹盆腔超声显示大量腹水。腹水性质为渗出液。所有肿瘤标志物均正常,但腹水及血清肿瘤CA125水平显著升高。腹部CT显示左侧附件区畸胎瘤及右侧附件区囊实性改变。
组织学及免疫组化结果符合JGCT。根据国际妇产科联盟(FIGO)分类,仅伴有恶性腹水的患者被归类为IC期。
患者接受了肿瘤切除及输卵管卵巢切除术。术后,她接受了6个疗程的奈达铂和紫杉醇脂质体辅助化疗。
患者术后随访至今6个月,无复发。
我们应高度警惕以大量腹水为首发临床表现的JGCT。