Chi Hsi-Ping, Tozzi Roberto, Moore Niall R
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
BJR Case Rep. 2016 Jul 27;3(1):20150416. doi: 10.1259/bjrcr.20150416. eCollection 2017.
A 48-year-old female with a 9-year history of granulosa cell tumour presented with progression of a mass in the left flank after the recent gradual rise of her inhibin B levels. She had experienced multiple recurrences and had undergone multiple operations to resect previous tumour recurrences. Initial laparoscopy did not identify the most recent recurrent mass. MRI was repeated a month after the surgery; it confirmed the presence of the mass and demonstrated an increase in the size of the tumour. Owing to difficulties in finding the tumour, a CT-guided wire localization of the mass was performed immediately prior to a second elective laparoscopy, leading to successful removal of the recurrent granulosa cell tumour. We describe the use of a conventional localization wire under CT guidance to facilitate the resection of a unique retroperitoneal tumour. This case report discusses the current applications of the wire localization technique, the evolution of the hook wire system, the potential complications that may occur and the factors influencing the likelihood of success of wire localization in the retroperitoneal space.
一名48岁女性，有9年颗粒细胞瘤病史，近期抑制素B水平逐渐升高后，左侧腹肿物进展。她经历了多次复发，并接受了多次手术切除先前的肿瘤复发灶。初次腹腔镜检查未发现最新的复发肿物。术后1个月复查MRI，证实肿物存在且肿瘤大小增大。由于难以找到肿瘤，在第二次择期腹腔镜检查前立即进行了CT引导下肿物钢丝定位，成功切除了复发性颗粒细胞瘤。我们描述了在CT引导下使用传统定位钢丝以利于切除独特的腹膜后肿瘤。本病例报告讨论了钢丝定位技术的当前应用、钩形钢丝系统的演变、可能发生的潜在并发症以及影响腹膜后间隙钢丝定位成功可能性的因素。
