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妊娠期良性卵巢肿瘤:初孕时异时性同侧复发性黏液性囊腺瘤及次孕时成熟性囊性畸胎瘤一例报告

Benign Ovarian Tumors in Pregnancy: A Case Report of Metachronous Ipsilateral Recurrent Mucinous Cystadenoma in Initial Pregnancy and Mature Cystic Teratoma in Subsequent Pregnancy.

作者信息

Schreck Arielle M, Mikdachi Hana F

机构信息

Obstetrics and Gynecology, East Tennessee State University, Quillen College of Medicine, Johnson City, USA.

出版信息

Cureus. 2019 Jan 3;11(1):e3818. doi: 10.7759/cureus.3818.

DOI:10.7759/cureus.3818
PMID:30868032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6402862/
Abstract

Mucinous cystadenomas of the ovary are benign epithelial neoplasms that can grow rapidly during pregnancy. They may cause ovarian torsion, virilization, inferior vena cava syndrome, and even preterm labor and fetal growth restriction. Various theories exist regarding the pathogenesis of these tumors. One hypothesis suggests that they may arise from teratomas. Our case report describes synchronous mucinous cystadenomas and ovarian teratomas, as well as metachronous mucinous cystadenomas in patients with a history of ovarian teratoma. There has been no report of metachronous ipsilateral teratoma after previous mucinous cystadenoma. We present a 22-year-old female with a history of bilateral ovarian tumors in a prior pregnancy noted to have a recurrent ovarian mass on her left ovary at the time of cesarean section of a subsequent pregnancy. She had two prior cystectomies for metachronous mucinous cystadenomas of her left ovary, and a right salpingo-oophorectomy for the ovarian torsion in her previous pregnancy. On her current pregnancy, she developed a mature cystic teratoma of the remaining left ovary. The rapid growth and recurrence rate of these tumors highlights the importance of close surveillance of ovarian masses during pregnancy, even those that seem benign. In this case, a history of unilateral salpingo-oophorectomy with multiple contralateral cystectomies did not appear to affect her fertility. Her future ovarian reserve is unknown, pointing to the need for adequate pre-operative counseling in similar cases of ovarian masses in pregnancy.

摘要

卵巢黏液性囊腺瘤是良性上皮性肿瘤,在孕期可迅速生长。它们可能导致卵巢扭转、男性化、下腔静脉综合征,甚至早产和胎儿生长受限。关于这些肿瘤的发病机制存在多种理论。一种假说认为它们可能起源于畸胎瘤。我们的病例报告描述了同步发生的黏液性囊腺瘤和卵巢畸胎瘤,以及有卵巢畸胎瘤病史患者的异时性黏液性囊腺瘤。此前尚无关于先前黏液性囊腺瘤后异时性同侧畸胎瘤的报告。我们报告一名22岁女性,既往妊娠时有双侧卵巢肿瘤病史,此次妊娠剖宫产时发现左卵巢有复发性肿物。她曾因左卵巢异时性黏液性囊腺瘤接受过两次囊肿切除术,上一次妊娠时因卵巢扭转接受了右侧输卵管卵巢切除术。此次妊娠时,她剩余的左卵巢发生了成熟性囊性畸胎瘤。这些肿瘤的快速生长和复发率凸显了孕期密切监测卵巢肿物的重要性,即使那些看似良性的肿物。在本病例中,单侧输卵管卵巢切除术加多次对侧囊肿切除术的病史似乎并未影响她的生育能力。她未来的卵巢储备情况未知,这表明在孕期类似卵巢肿物病例中需要进行充分的术前咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/8e5cf2a79e93/cureus-0011-00000003818-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/5617e1838e2f/cureus-0011-00000003818-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/836c790fe8ba/cureus-0011-00000003818-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/8e5cf2a79e93/cureus-0011-00000003818-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/5617e1838e2f/cureus-0011-00000003818-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/836c790fe8ba/cureus-0011-00000003818-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ee/6402862/8e5cf2a79e93/cureus-0011-00000003818-i03.jpg

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本文引用的文献

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Repeated pregnancy with concomitant presence of ovarian teratoma: A case report and literature review.重复妊娠合并卵巢畸胎瘤:一例报告及文献综述
Taiwan J Obstet Gynecol. 2017 Oct;56(5):694-696. doi: 10.1016/j.tjog.2017.08.021.
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A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy.一例巨大卵巢黏液性囊腺瘤在孕期导致男性化、早产及持续性仰卧位低血压综合征。
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Collision tumours of ovary: a very rare case series.
卵巢碰撞瘤:一组极其罕见的病例
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Metachronous benign ovarian tumors are not uncommon in children.异时性良性卵巢肿瘤在儿童中并不罕见。
J Pediatr Surg. 2014 Apr;49(4):543-5. doi: 10.1016/j.jpedsurg.2013.09.019. Epub 2013 Oct 3.
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Adnexal masses encountered during cesarean delivery.剖宫产术中遇到的附件包块。
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Mature embryoid teratoma in the wall of a mucinous cyst adenoma of ovary in multiparous female.经产妇卵巢黏液性囊腺瘤壁内成熟性胚胎样畸胎瘤。
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Mucinous cystadenoma arising 3 years after ovarian-sparing surgery for mature teratoma in a child.儿童成熟畸胎瘤行保留卵巢手术后 3 年发生黏液性囊腺瘤。
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