Allen Rebecca, Lakasing Lorin
Imperial College Healthcare NHS Trust, London, UK.
Department of Obstetrics, St Mary's Hospital, London, UK.
BMJ Case Rep. 2019 Aug 4;12(8):e229438. doi: 10.1136/bcr-2019-229438.
A 36-year-old pregnant woman attended her first trimester scan and there was an incidental finding of a right-sided complex cystic adenexal mass. Further investigations including repeat pelvic ultrasound scans and MRI were performed due to its complex nature but were inconclusive. Multidisciplinary team review of images found the mass to be retroperitioneal, neurogenic in origin and involving the L5 vertebrae. The pregnancy continued to term and the baby was delivered at 39 weeks gestation by elective caesarean section due to the mass being likely to obstruct progress in labour. Postnatal biopsy confirmed a schwannoma. Plans were made for resection however as the woman was asymptomatic she declined surgery in favour of completing her family. She conceived again 2 years later and a second pregnancy was managed in the same way. The size of the schwannoma remained stable throughout this period.
一名36岁的孕妇进行了孕早期超声检查，偶然发现右侧附件区有一个复杂的囊性肿块。由于其性质复杂，进一步进行了包括重复盆腔超声扫描和磁共振成像（MRI）在内的检查，但结果不明确。多学科团队对影像进行评估后发现该肿块位于腹膜后，起源于神经，累及L5椎体。妊娠持续至足月，由于肿块可能阻碍产程进展，在妊娠39周时通过择期剖宫产分娩。产后活检证实为神经鞘瘤。计划进行切除手术，但由于该女子无症状，她拒绝手术，希望完成生育计划。两年后她再次怀孕，第二次妊娠的处理方式相同。在此期间，神经鞘瘤的大小保持稳定。
