Mun Seong Taek, Jang Si-Hyong, Ryu Aeli
Department of Obstetrics and Gynecology.
Department of Pathology, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
Medicine (Baltimore). 2018 Oct;97(40):e12669. doi: 10.1097/MD.0000000000012669.
Ovarian cancer has the poorest prognosis of the gynecological cancers. Early diagnosis and treatment are important, but early-stage ovarian carcinoma has nonspecific symptoms. Ultrasonography, computed tomography, magnetic resonance imaging, and serum CA-125 levels can be helpful but may not elucidate cases of diffuse peritoneal diseases mimicking carcinomatosis.
The patient had intermittent abdominal discomfort and dysuria. Abdominal-pelvic computed tomography findings were suspicious for peritoneal tuberculosis (TB) and a small cystic mass in the left ovary. The CA-125 values were normal.
She underwent laparoscopy for pathologic confirmation of tuberculous peritonitis and management of the ovary mass. Bilateral adnexectomy was performed. Histopathological examination of the surgical specimen revealed a serous ovarian carcinoma in her left ovary and salpinx.
Laparoscopic hysterectomy, pelvic lymphadenectomy, para-aortic nodal dissection, and omentectomy were carried out for staging evaluation.
We encountered a rare case of ovary cancer stage IA serous ovarian carcinoma incidentally discovered by laparoscopy in a postmenopausal woman. She received adjuvant chemotherapy without relapse.
Peritoneal TB may mimic peritoneal or ovarian carcinoma, but the reverse case is rare. Hence, gynecologists should be careful in assessment of patients before treatment.
卵巢癌在妇科癌症中预后最差。早期诊断和治疗很重要，但早期卵巢癌症状不具特异性。超声检查、计算机断层扫描、磁共振成像以及血清CA-125水平可能有帮助，但可能无法明确诊断模仿癌病的弥漫性腹膜疾病病例。
患者有间歇性腹部不适和排尿困难。腹盆腔计算机断层扫描结果怀疑为腹膜结核以及左卵巢有一个小囊性肿块。CA-125值正常。
她接受了腹腔镜检查以进行结核性腹膜炎的病理确诊和卵巢肿块的处理。进行了双侧附件切除术。手术标本的组织病理学检查显示其左卵巢和输卵管存在浆液性卵巢癌。
进行了腹腔镜子宫切除术、盆腔淋巴结清扫术、腹主动脉旁淋巴结清扫术和大网膜切除术以进行分期评估。
我们遇到了一例罕见的绝经后女性腹腔镜偶然发现的IA期浆液性卵巢癌病例。她接受了辅助化疗且未复发。
腹膜结核可能模仿腹膜或卵巢癌，但相反的情况很少见。因此，妇科医生在治疗前评估患者时应谨慎。
