Médico ginecobstetra, especialista Unidad Medicina Materno-Fetal, Clínica Universitaria Colombia. Bogotá (Colombia).
Médico ginecobstetra, especialista Unidad Medicina Materno-Fetal, Clínica Universitaria Colombia; docente Universidad Nacional de Colombia. Bogotá (Colombia).
Rev Colomb Obstet Ginecol. 2020 Jun;71(2):195-207. doi: 10.18597/rcog.3477.
To report the case of a pregnant patient diagnosed with a primary retroperitoneal tumor and to conduct a review of the literature pertaining to the diagnosis, treatment and maternal-fetal prognosis of this disease condition during pregnancy.
A 19-year-old patient who presented with a retroperitoneal tumor identified on ultrasound. The results of the percutaneous biopsy showed a benign tumor. A healthy neonate was delivered by cesarean section. Surgical resection was performed four months later, and histopathology showed a mature cystic teratoma. A search was conduced in the Medline via PubMed, Lilacs, SciELO and ScienceDirect databases using the terms "pregnancy," "neoplasms," and "retroperitoneal neoplasms," including case reports and case series of retroperitoneal tumors during pregnancy. Diagnosis, treatment and maternal-fetal prognosis were identified.
Overall, 1658 titles were identified. Of these, 34 case reports and 1 case series met the inclusion criteria. Of the cases, 62.9 % were benign. Diagnosis was made as an incidental finding in 63 % of cases, and 77 % of the masses were identified on ultrasound. Percutaneous biopsy was used in 8 % of cases, including the case reported here. Surgical treatment was used in 88 % of cases usually after delivery. Maternal mortality occurred in 8.5 % of cases. Fetal prognosis was good in 65 % of the pregnancies.
Despite being frequently benign, retroperitoneal tumors during gestation have a reserved maternal and fetal prognosis in a substantial number of cases. There is a need to assess the risks and benefits of percutaneous biopsy.
报告 1 例妊娠合并原发性腹膜后肿瘤患者，并对妊娠合并腹膜后肿瘤的诊断、治疗及母婴预后的相关文献进行复习。
回顾性分析 1 例超声检查发现腹膜后肿瘤的 19 岁患者的临床资料。经皮穿刺活检结果提示良性肿瘤，行剖宫产术娩出 1 名健康新生儿，术后 4 个月行手术切除，术后病理回报为成熟囊性畸胎瘤。检索 Medline 数据库（Pubmed 数据库、Lilacs 数据库、SciELO 数据库和 ScienceDirect 数据库）、维普及万方数据库中关于“妊娠、肿瘤、腹膜后肿瘤”的文献，包括腹膜后肿瘤的病例报告和病例系列研究，总结妊娠合并腹膜后肿瘤的诊断、治疗及母婴预后。
共检索到 1658 篇文献，其中 34 篇病例报告和 1 篇病例系列研究符合纳入标准。肿瘤性质以良性为主（62.9%），63.0%为偶然发现，77.0%的肿瘤通过超声检查发现。8.0%的患者接受了经皮穿刺活检，包括本文患者。88.0%的患者接受了手术治疗，通常在分娩后进行。8.5%的患者出现了母体死亡，65.0%的妊娠结局良好。
尽管腹膜后肿瘤多为良性，但仍有相当一部分妊娠合并腹膜后肿瘤患者母婴预后较差，需要评估经皮穿刺活检的风险和获益。
