Oliveira João Diogo, Cunha Teresa Margarida, Tereso Andreia
Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
Radiol Bras. 2020 Sep-Oct;53(5):349-355. doi: 10.1590/0100-3984.2019.0073.
Although secondary involvement of the broad ligament by malignant tumors arising elsewhere in the abdomen and pelvis is common, primary tumors in this location are rare. Tumors of the broad ligament can be of mesenchymal and mixed nature, such as leiomyoma, the most common neoplasm; epithelial tumors of Müllerian type, imposing a challenge to differentiate them from other adnexal masses; unique tumors from mesonephric origin; and tumor-like lesions. Most neoplasms in this region, whether benign or malignant, usually present clinically with vague symptoms and are often discovered during a routine gynecological examination. Suspicion of such location and knowledge of the potential range of lesions of this region may allow for planning minimally invasive surgical interventions. To be considered tumor from the broad ligament, it should not be connected with either the uterus or the ovary. Thus, the imaging approach to establish the differential diagnosis includes excluding an ovarian, uterine, or tubal origin by recognizing these separately and by rebutting imaging clues pointing to these origins. This pictorial essay reviews some of the imaging findings that may suggest such location and presents some of the possible differential diagnoses by means of illustrative confirmed cases.
尽管腹部和盆腔其他部位发生的恶性肿瘤继发累及阔韧带很常见，但该部位的原发性肿瘤却很罕见。阔韧带肿瘤可以是间叶性和混合性的，如最常见的肿瘤平滑肌瘤；苗勒管型上皮肿瘤，将其与其他附件肿块区分开来具有挑战性；中肾起源的独特肿瘤；以及肿瘤样病变。该区域的大多数肿瘤，无论良性还是恶性，临床上通常表现为模糊症状，常在常规妇科检查时被发现。怀疑有此类部位病变并了解该区域潜在病变范围，可能有助于规划微创外科手术干预。要被认定为阔韧带肿瘤，它不应与子宫或卵巢相连。因此，用于建立鉴别诊断的影像学方法包括通过分别识别并排除指向卵巢、子宫或输卵管起源的影像学线索，来排除卵巢、子宫或输卵管起源。这篇图文并茂的文章回顾了一些可能提示该部位病变的影像学表现，并通过一些经证实的病例说明展示一些可能的鉴别诊断。
