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乳酸脱氢酶升高——硬化性间质瘤诊断中的干扰因素:一例报告

Elevated lactate dehydrogenase - A red herring in the diagnosis of a sclerosing stromal tumor: A case report.

作者信息

Devlin Kelly, Gross Alexander, Flanagan Melina, Pfaendler Krista

机构信息

Department of Obstetrics, Gynecology and Reproductive Sciences; West Virginia University School of Medicine; 1 Medical Center Drive, Morgantown, WV 26506, USA.

Department of Pathology, Microbiology, and Immunology; Vanderbilt University Medical Center; 2301 Vanderbilt Place, Nashville, TN 37235, USA.

出版信息

Case Rep Womens Health. 2024 Jul 9;43:e00633. doi: 10.1016/j.crwh.2024.e00633. eCollection 2024 Oct.

Abstract

Sclerosing stromal tumors are a rare type of ovarian tumor in the category of sex cord stromal tumors, which arise from the ovarian connective tissue. This report concerns a case of a sclerosing stromal tumor in a 19-year-old nulliparous woman who presented with the chief complaints of menstrual irregularities and dyspareunia. Preoperative imaging revealed a complex right adnexal mass with blood flow and without associated ascites. Tumor markers were all normal except lactate dehydrogenase, which was elevated. The elevated lactate dehydrogenase, in combination with patient age and menstrual irregularities, initially misdirected the clinicians toward suspicion for dysgerminoma or other malignant germ cell tumor of the ovary. Clinicians should beware of excluding the diagnosis of sex cord stromal tumor on the differential in a young person with an adnexal mass and elevated lactate dehydrogenase.

摘要

硬化性间质瘤是性索间质肿瘤类别中一种罕见的卵巢肿瘤,起源于卵巢结缔组织。本报告涉及一名19岁未生育女性的硬化性间质瘤病例,该患者主要主诉为月经不调和性交困难。术前影像学检查显示右侧附件有一个复杂的肿块,有血流信号且无相关腹水。除乳酸脱氢酶升高外,肿瘤标志物均正常。乳酸脱氢酶升高,结合患者年龄和月经不调,最初使临床医生怀疑为卵巢无性细胞瘤或其他恶性生殖细胞肿瘤。临床医生应注意,在鉴别诊断附件肿块且乳酸脱氢酶升高的年轻患者时,不要排除性索间质肿瘤的诊断。

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