腹腔镜手术后囊性卵巢肿瘤发生未分化癌：一例病例研究
Undifferentiated Carcinoma After Laparoscopic Surgery for a Cystic Ovarian Tumour: A Case Study.
作者信息
Shigematsu Kosuke, Samejima Koki, Sawada Keisuke, Uotani Takahiro, Akahori Taichi, Matsunaga Shigetaka, Nagai Tomonori, Tamaru Jun-Ichi, Takai Yasushi
机构信息
Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Department of Pathology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
出版信息
Cancer Diagn Progn. 2021 Nov 3;1(5):499-505. doi: 10.21873/cdp.10067. eCollection 2021 Nov-Dec.
BACKGROUND
Laparoscopic surgery for malignant tumours occasionally results in recurrence at the trocar insertion site or port-site metastasis (PSM). We report on a patient requiring emergency laparoscopic surgery for an ovarian tumour with a review of the relevant literature.
CASE REPORT
A 42-year-old woman developed sudden abdominal pain and underwent laparoscopic right adnexectomy because of a suspected ovarian cystic tumour rupture. The postoperative histological diagnosis was a mucinous borderline ovarian tumour; however, an undifferentiated carcinoma was detected at the port site eight months after the initial surgery. The histopathological diagnosis of the abdominal wall tumour at the port site differed from intraoperative pathological findings, which was contradictory to PSM definition. Postoperatively, she received three systemic chemotherapy courses but died consequent to tumour metastasis.
CONCLUSION
This is an atypical PSM case with histopathological differences from the initial tumour. Careful preoperative diagnosis and intraoperative attention are essential in such cases.
背景
腹腔镜手术治疗恶性肿瘤偶尔会导致套管针穿刺部位复发或端口部位转移（PSM）。我们报告一例因卵巢肿瘤需要急诊腹腔镜手术的患者，并对相关文献进行综述。
病例报告
一名42岁女性突发腹痛，因疑似卵巢囊性肿瘤破裂接受了腹腔镜右附件切除术。术后组织学诊断为黏液性交界性卵巢肿瘤；然而，在初次手术后8个月，在端口部位检测到未分化癌。端口部位腹壁肿瘤的组织病理学诊断与术中病理结果不同，这与PSM的定义相矛盾。术后，她接受了三个疗程的全身化疗，但因肿瘤转移死亡。
结论
这是一例非典型的PSM病例，其组织病理学与原发肿瘤不同。在此类病例中，术前仔细诊断和术中密切关注至关重要。
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