Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China.
J Int Med Res. 2020 Oct;48(10):300060520949410. doi: 10.1177/0300060520949410.
Most cases of female genital tuberculosis (TB) are asymptomatic and are thus difficult to diagnose. Coexistence of genital TB and ovarian serous cystadenofibroma (OSCAF) is rare and easily ignored or misdiagnosed. We report a 26-year-old woman with coexistence of genital TB and OSCAF, and with an adnexal mass detected by B-ultrasound. Laparoscopic biopsy of diffuse miliary white nodules was performed on the surface of the peritoneum and both fallopian tubes. Right ovarian cystectomy was performed. Postoperative pathology showed that the right ovarian mass was a benign serous cystadenofibroma, and both fallopian tubes and miliary white nodules on the surface of pelvic organs showed chronic granulomatous inflammation. Polymerase chain reaction for tuberculosis and acid-fast bacilli culture were positive in biopsies of the fallopian tubes, omentum, and peritoneum. The patient received anti-TB treatment after surgery. Six months after the operation, the patient had no abdominal pain and no major changes in menstruation. Our findings suggest that a timely operation is required for patients with an adnexal mass. During surgery, even if the lesion is similar to a malignant tumor, the surgical approach needs to be cautiously chosen for young patients without children. The patient's postoperative fertility must be taken into consideration.
大多数女性生殖器结核病(TB)病例无症状,因此难以诊断。生殖器 TB 和卵巢浆液性囊腺瘤纤维瘤(OSCAF)同时存在的情况很少见,容易被忽视或误诊。我们报告了一例 26 岁女性,同时存在生殖器 TB 和 OSCAF,超声检查发现附件肿块。对腹膜和双侧输卵管表面弥漫性粟粒状白色结节进行腹腔镜活检。行右侧卵巢囊肿切除术。术后病理显示右侧卵巢肿块为良性浆液性囊腺瘤纤维瘤,盆腔器官表面的双侧输卵管和粟粒状白色结节均表现为慢性肉芽肿性炎症。输卵管、大网膜和腹膜活检的结核聚合酶链反应和抗酸杆菌培养均为阳性。术后患者接受了抗结核治疗。术后 6 个月,患者无腹痛,月经无明显变化。我们的研究结果表明,对于附件肿块患者,需要及时进行手术。手术过程中,即使病变类似于恶性肿瘤,对于没有生育的年轻患者,手术方法的选择也需要谨慎。必须考虑患者的术后生育能力。