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妊娠合并卵巢未成熟畸胎瘤 1 例报告。

Ovarian dysgerminoma in pregnancy: A case report.

机构信息

Department of Obstetrics and Gynecology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Romania, Eftimie Murgu Sq. no. 2, Timişoara, RO.

出版信息

Medicine (Baltimore). 2021 Apr 9;100(14):e25364. doi: 10.1097/MD.0000000000025364.

Abstract

RATIONALE

Although dysgerminomas are relatively uncommon among all ovarian neoplasms, representing for only about 2%, they account for 32.8 percent of malignant ovarian germ cell tumors. Their association with pregnancy is extremely rare; due to the low frequency of occurrence, there are few recommendations regarding pregnancy management; therefore, it is important to discuss and summarize the treatment strategy.

PATIENT CONCERNS

We present the case of a 25 years patient, gestation 1, para 1, who was hospitalized in the clinic at 38/39 weeks of gestation at the beginning of labor. Following the ultrasound examination, a hypoechogenic lesion on the uterine fundus was found, suggestive of subterranean fibroid. After caesarean section, right adnexectomy was performed; the histopathological examination revealed, unexpectedly, the diagnosis of dysgerminoma.

DIAGNOSES

Dysgerminoma as associated with pregnancy.

INTERVENTIONS

Birth by Caesarean section and right adnexectomy. No other medical complications occurred.

OUTCOMES

The histopathological and immunohistochemical examinations were consistent with the pure dysgerminoma. Oncology was staged AI, with the monitoring of markers and abdominal and pelvic magnetic resonance imaging at 3, 6, 9, and 12 months.

LESSONS

Dysgerminoma is the most common ovarian malignancy associated with pregnancy with a good fetal maternal outcome. If these tumors are discovered accidentally during caesarean section, tumor markers and magnetic resonance imaging scanning should be done postoperatively to plan optimal treatment.

摘要

背景

虽然卵原细胞瘤在所有卵巢肿瘤中相对少见,仅占 2%左右,但它们占恶性卵巢生殖细胞肿瘤的 32.8%。它们与妊娠的关联极为罕见;由于发生率低,关于妊娠管理的建议很少;因此,讨论和总结治疗策略非常重要。

病例介绍

我们报告了一位 25 岁妊娠 1 产 1 位的患者,在分娩开始时 38/39 孕周住院。超声检查后,发现子宫底部有一个低回声病变,提示为地下肌瘤。剖宫产术后行右侧附件切除术;组织病理学检查出乎意料地诊断为卵原细胞瘤。

诊断

卵原细胞瘤与妊娠相关。

干预措施

剖宫产术和右侧附件切除术。无其他医疗并发症发生。

结果

组织病理学和免疫组织化学检查与纯卵原细胞瘤一致。肿瘤分期为 AI,术后监测标志物和腹部及盆腔磁共振成像,分别在 3、6、9 和 12 个月进行。

教训

卵原细胞瘤是最常见的与妊娠相关的卵巢恶性肿瘤,母婴结局良好。如果这些肿瘤在剖宫产术中意外发现,术后应进行肿瘤标志物和磁共振成像扫描,以规划最佳治疗方案。

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