Amara Ayoub, Adem Amine, Salhi Hanane, El Magroud Mohammed, Zaari Najlae, Ammor Abdelouahab, Benhaddou Houssaine
Centre Hospitalier Universitaire Mohammed VI, Oujda, Morocco.
Faculty of Medicine and Pharmacy, University of Mohammed First, Oujda, Morocco.
SAGE Open Med Case Rep. 2024 Oct 31;12:2050313X241296296. doi: 10.1177/2050313X241296296. eCollection 2024.
Ovarian tumours occur at an incidence rate of 2.6 cases per 100,000 children, and their frequency escalates proportionally with age. These tumours typically have an organic origin and are seldom functional. The frequent presence of pain primarily characterizes the clinical manifestation of ovarian cysts. The complexity inherent in analyzing this pain can complicate diagnosis, necessitating a thorough evaluation that could potentially require resorting to a pelvic ultrasound to confirm the diagnosis and determine the optimal management. Additional imaging techniques and tumour marker assays aid in specifying the nature of this mass, where surgery remains the sole therapeutic option. The histopathological analysis further confirms the precise nature of the mass or cyst to establish a prognosis and guide the management strategies and progression follow-up. Our case is for a girl aged 15 years old without notable medical history, presenting at admission with a 6-month history of a gradually enlarging abdominal mass associated with abdominal pain and tumour markers (BHCG was negative). In addition, LDH, CA125, Inhibin, CEA and CA19.9 were negative. Radiologically, the ultrasound revealed a huge cystic abdominopelvic mass occupying the entirety of the abdomen and pelvis with posterior compression of the intestines without visualization of the left ovary; the right ovary appeared normal. MRI confirmed the presence of a voluminous intraperitoneal abdominopelvic cystic formation measuring 31 × 20 × 8 cm. The patient underwent laparoscopic surgery, revealing a large cystic mass with septations filling the abdomen and pelvis and displacing the gastrointestinal tract. After draining 6 L of clear fluid, the entire cyst was removed while preserving some left ovarian tissue, with the right ovary appearing normal. The follow-up is still ongoing, with the last consultation being 8 months post-operative.
卵巢肿瘤在每10万名儿童中的发病率为2.6例，其发病率随年龄成比例上升。这些肿瘤通常起源于器质性病变，很少具有功能性。疼痛的频繁出现是卵巢囊肿临床表现的主要特征。分析这种疼痛的复杂性会使诊断复杂化，因此需要进行全面评估，这可能需要借助盆腔超声来确诊并确定最佳治疗方案。其他影像学技术和肿瘤标志物检测有助于明确该肿块的性质，而手术仍然是唯一的治疗选择。组织病理学分析进一步确定肿块或囊肿的确切性质，以制定预后并指导治疗策略和病情进展随访。我们的病例是一名15岁女孩，无明显病史，入院时主诉有6个月逐渐增大的腹部肿块，伴有腹痛，肿瘤标志物（β-HCG为阴性）。此外，乳酸脱氢酶（LDH）、癌抗原125（CA125）、抑制素、癌胚抗原（CEA）和癌抗原19.9均为阴性。放射学检查显示，超声发现一个巨大的囊实性腹盆腔肿块，占据整个腹部和盆腔，压迫肠管，未显示左卵巢；右卵巢外观正常。磁共振成像（MRI）证实存在一个巨大的腹腔内腹盆腔囊性肿物，大小为31×20×8cm。患者接受了腹腔镜手术，发现一个大的囊性肿块，有分隔，充满腹部和盆腔，推移了胃肠道。抽出6升清亮液体后，完整切除整个囊肿，同时保留了部分左侧卵巢组织，右侧卵巢外观正常。随访仍在进行中，最后一次会诊是在术后8个月。
