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青少年卵巢畸胎瘤致输尿管积水:病例报告及文献复习。

Ovarian teratoma in a teenager causing ureterohydronephrosis: Case report and literature review.

机构信息

Discipline of Pediatrics.

Discipline of Rehabilitation in Pediatrics, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.

出版信息

Medicine (Baltimore). 2021 Jul 9;100(27):e26472. doi: 10.1097/MD.0000000000026472.

Abstract

RATIONALE

Teratomas are solid tumors that may occur in both gonadal and extragonadal locations, depending on the age of the child. Benign cystic teratomas are relatively common tumors among women of reproductive age, but they can occur at any age. The clinical presentation is not specific. They can be found incidentally when patients are investigated for other conditions or they can present as emergencies when the ovarian teratoma is torsioned or ruptured.

PATIENT CONCERNS

We present the case of a 17-year-old adolescent girl that was seen in our emergency department on several occasions for recurrent episodes of abdominal pain ongoing for 6 months.

DIAGNOSIS

An ultrasonography (US) was performed as an outpatient and a left ovarian mass was found along with right ureterohydronephrosis (UHN). Further assessment of the mass was done by abdominal and pelvic CT and tumoral markers. CT appearance was more suggestive of a teratoma.

INTERVENTIONS

She underwent laparotomy with complete excision of the tumor.

OUTCOME

The patient had an uneventful recovery. A renal US follow up showed reduction of the dilatation, demonstrating that the condition was secondary to tumor compression.

LESSONS

In a teenager with nonspecific symptoms, a high suspicion index for tumors is mandatory. An early diagnosis and management avoid complications like UHN.

摘要

背景

畸胎瘤是一种可能发生在性腺和性腺外部位的实体肿瘤,这取决于儿童的年龄。良性囊性畸胎瘤是育龄妇女中相对常见的肿瘤,但也可发生于任何年龄。临床表现不具有特异性。当患者因其他疾病接受检查时,可能会偶然发现这些肿瘤,或者当卵巢畸胎瘤发生扭转或破裂时,可能会出现紧急情况。

病例介绍

我们报告了一例 17 岁的青春期少女,她因反复发作的腹痛已在我院急诊科就诊数次,腹痛持续了 6 个月。

诊断

作为门诊患者进行了超声检查,发现左侧卵巢肿块,同时伴有右侧输尿管积水。进一步对肿块进行了腹部和盆腔 CT 以及肿瘤标志物检查。CT 表现更提示为畸胎瘤。

干预措施

患者接受了剖腹手术,完全切除了肿瘤。

结果

患者恢复顺利。肾超声随访显示扩张程度减轻,表明该情况是由肿瘤压迫引起的。

教训

对于有非特异性症状的青少年,必须高度怀疑肿瘤。早期诊断和治疗可避免输尿管积水等并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5294/8270627/83fd460a26de/medi-100-e26472-g001.jpg

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