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伴有瘤内出血的腹膜后平滑肌瘤:以多器官功能障碍综合征为表现——病例报告

Retroperitoneal leiomyomas with intratumoral bleeding: Presentation with multiple-organ dysfunction syndrome - A case report.

作者信息

Wang Shishi, Li Lihua, Lin Ying, Su Jiawei, Shen Minghong, Lin Tan

机构信息

Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, China.

Department of Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, China.

出版信息

Heliyon. 2024 Aug 9;10(16):e36075. doi: 10.1016/j.heliyon.2024.e36075. eCollection 2024 Aug 30.

Abstract

BACKGROUND

Retroperitoneal leiomyomas are rare benign smooth muscle tumours. Diagnosing these tumours is often challenging due to their unique growth site and nonspecific clinical manifestations. There are a few reports of leiomyomas with intratumoral bleeding.

CASE PRESENTATION

A patient with a giant retroperitoneal leiomyoma presented with multiple-organ dysfunction syndrome accompanied by a progressive decrease in haemoglobin. Computed tomography (CT) revealed two cystic tumours in the abdominal cavity. The patient was underwent transabdominal retroperitoneal tumour resection. During surgery, we found two retroperitoneal tumours-one contained approximately 9000 mL of dark red fluid and the other contained 1000 mL of light brown fluid. She has recovered well without any complications.

CONCLUSIONS

There have been only a few reports of retroperitoneal leiomyomas with intratumoral bleeding. This case highlights the importance of recognizing intratumoral haemorrhage in patients with large leiomyomas and a progressive decrease in haemoglobin after ruling out external haemorrhage. If necessary, dynamic monitoring via CT may help clarify the diagnosis.

摘要

背景

腹膜后平滑肌瘤是罕见的良性平滑肌肿瘤。由于其独特的生长部位和非特异性临床表现,诊断这些肿瘤往往具有挑战性。有少数关于肿瘤内出血的平滑肌瘤的报道。

病例介绍

一名患有巨大腹膜后平滑肌瘤的患者出现多器官功能障碍综合征,同时血红蛋白进行性下降。计算机断层扫描(CT)显示腹腔内有两个囊性肿瘤。该患者接受了经腹腹膜后肿瘤切除术。手术中,我们发现两个腹膜后肿瘤——一个含有约9000毫升暗红色液体,另一个含有1000毫升浅棕色液体。她恢复良好,无任何并发症。

结论

仅有少数关于腹膜后平滑肌瘤伴肿瘤内出血的报道。该病例强调了在排除外部出血后,认识到大的平滑肌瘤患者出现肿瘤内出血及血红蛋白进行性下降的重要性。必要时,通过CT进行动态监测可能有助于明确诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f649/11367416/647050912634/gr1.jpg

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