Mesarieki Lobulu Vincent, Macheku Godwin Silas, Kayombo Geofrey Oscary, Minga Benard Laurent, Sadiq Adnan, Mremi Alex
Department of General Surgery, Mawenzi Regional Referral Hospital, Moshi, Tanzania.
Department of Obstetrics and Gynecology, Mawenzi Regional Referral Hospital, Moshi, Tanzania.
Int J Surg Case Rep. 2025 Jan;126:110753. doi: 10.1016/j.ijscr.2024.110753. Epub 2024 Dec 18.
Ovarian atypical proliferative mucinous tumor (APMT) is a low-malignant or borderline tumor that originates from the ovary's surface epithelium. This tumor can grow to a massive size, causing abdominal distention, which can result in a variety of compression symptoms if it is not discovered early.
A 23-year-old female presented with a chronic, gradually developing abdominal distention that had been persistent for a year. A large peritoneal cyst was suggested by an abdominal CT scan. A massive left ovarian tumor was discovered during an exploratory laparotomy. Salpingo-oophorectomy was performed, and the pathology report confirmed the diagnosis of APMT. No recurrence has been observed during a year of follow-up.
Diagnosis of ovarian APMBT involves clinical assessment, history, and symptoms of the patient. Imaging studies are useful in identifying these lesions. Ultrasound demonstrates a large, unilocular or multilocular cystic mass with thin septations. Further characterization requires an MRI or CT scan. Serum tumor markers such as CEA, CA-125, and β-hCG are helpful in diagnosing these lesions. The definitive diagnosis requires histopathological examination. Unilateral salpingo-oophorectomy is the mainstay of treatment. Adjuvant therapy is not required. Lifelong follow-up is essential, especially for fertility-sparing surgeries due to recurrence risk.
Due to the substantial overlap of clinicopathological characteristics with other tumors, accurate diagnosis of APMT can be difficult. Large tumor sizes may cause alarm for other pathologies such as cancer. The attending physician should be reassured with the imaging examinations, and the diagnosis is confirmed by the histopathology examination.
卵巢非典型增生性黏液性肿瘤（APMT）是一种起源于卵巢表面上皮的低恶性或交界性肿瘤。这种肿瘤可生长至巨大体积，导致腹胀，如果不及早发现，可能会引发各种压迫症状。
一名23岁女性因慢性、逐渐加重的腹胀症状前来就诊，该症状已持续一年。腹部CT扫描提示有一个大的腹膜囊肿。在剖腹探查术中发现一个巨大的左侧卵巢肿瘤。进行了输卵管卵巢切除术，病理报告确诊为APMT。随访一年未观察到复发。
卵巢APMBT的诊断涉及对患者的临床评估、病史和症状。影像学检查有助于识别这些病变。超声显示一个大的、单房或多房的囊性肿块，有薄的分隔。进一步的特征性诊断需要MRI或CT扫描。血清肿瘤标志物如癌胚抗原（CEA）、糖类抗原125（CA-125）和β-人绒毛膜促性腺激素（β-hCG）有助于诊断这些病变。明确诊断需要组织病理学检查。单侧输卵管卵巢切除术是主要的治疗方法。不需要辅助治疗。终身随访至关重要，特别是对于保留生育功能的手术，因为存在复发风险。
由于APMT的临床病理特征与其他肿瘤有很大重叠，准确诊断可能具有挑战性。肿瘤体积大可能会让人担心其他病变，如癌症。主治医生应通过影像学检查来确诊，并通过组织病理学检查来证实诊断。
