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输卵管癌诊断性腹腔镜检查术后原发性并发症——穿刺孔转移:一例报告

Port-site metastasis as a primary complication following diagnostic laparoscopy of fallopian tube carcinoma: A case report.

作者信息

Chen Yan, Ling Chen, Bian Ce

机构信息

Department of Gynecology and Obstetrics, Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University Department of Gynecology and Obstetrics, Chengdu First People's Hospital, Chengdu, P. R. China.

出版信息

Medicine (Baltimore). 2018 Jun;97(26):e11166. doi: 10.1097/MD.0000000000011166.

Abstract

RATIONALE

Fallopian tube carcinoma is a rare female genital cancer with no specific clinical and surgical features. It is hardly diagnosed on imaging due to non-specific presentation. Laparoscopy has been recommended as the diagnostic procedure for the assessment of suspicious ovarian and adnexal masses. However, it has brought new complications like tumor recurrences at the trocar insertion sites, called port-site metastasis (PSM).

PATIENT CONCERNS

A 65-year-old, postmenopausal woman presented to hospital with loss of appetite, Ultrasound showed ill-defined pelvic mass. The patient was diagnosed with fallopian tube carcinoma by a diagnostic laparoscopy.

DIAGNOSES

The PSM as a primary complication following diagnostic laparoscopy of fallopian tube carcinoma, which is presumed by positron emission tomography/computed tomography and confirmed by Nodule resection and further pathological assessment.

INTERVENTIONS

As port-site metastasis was suspected, the patient was advised to undergo umbilical mass resection.

OUTCOMES

the patient has no signs of recurrence was detected 20 months after the last surgery during follow-up.

LESSIONS

Laparoscopy plays a significant role in the diagnose and treatment of fallopian tubal and ovarian malignancies but has a risk of PSM occurrence. When isolated PSM occurs the management should be local resection.

摘要

理论依据

输卵管癌是一种罕见的女性生殖系统癌症,没有特定的临床和手术特征。由于其表现不具特异性,很难通过影像学进行诊断。腹腔镜检查已被推荐作为评估可疑卵巢和附件肿块的诊断方法。然而,它带来了新的并发症,如在套管针穿刺部位出现肿瘤复发,即所谓的穿刺孔转移(PSM)。

患者情况

一名65岁的绝经后女性因食欲不振入院,超声显示盆腔肿块边界不清。该患者通过诊断性腹腔镜检查被诊断为输卵管癌。

诊断

PSM是输卵管癌诊断性腹腔镜检查后的主要并发症,通过正电子发射断层扫描/计算机断层扫描推测,并经结节切除和进一步病理评估证实。

干预措施

由于怀疑有穿刺孔转移,建议患者接受脐部肿块切除术。

结果

在最后一次手术后20个月的随访中,未发现患者有复发迹象。

经验教训

腹腔镜检查在输卵管和卵巢恶性肿瘤的诊断和治疗中发挥着重要作用,但有发生PSM的风险。当孤立性PSM发生时,治疗应采用局部切除。

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