Furuya Rachel L, Rimel Bobbie J, Tsai Richard, Brooks Rebecca Ann, Stewart Massad L, Thaker Premal H, Pfeifer John D
Department of Obstetrics and Gynecology, Washington University School of Medicine, MSC 8064-37-1005, 660 S. Euclid Ave, St. Louis, MO 63110, USA.
Division of Gynecologic Oncology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA.
Gynecol Oncol Rep. 2025 Mar 7;58:101712. doi: 10.1016/j.gore.2025.101712. eCollection 2025 Apr.
Epithelial ovarian cancer commonly presents with vague symptoms that delay diagnosis until disease is advanced. Granulomatous peritonitis is a term used to describe granulomatous inflammation within the peritoneal cavity and mimics advanced stage ovarian cancer clinically and on imaging. The goal of this study was to examine the frequency and characteristics of cases of granulomatous peritonitis mimicking ovarian cancer at a single institution and to describe the etiology in this population.
Eight cases were identified with pathology conformation of granulomatous disease and absence of cancer. The etiologies include pelvic tuberculosis, ruptured dermoid cyst, ruptured hemorrhagic corpus luteum, prior endometriosis surgery, xanthogranulomatous inflammation and three cases of tubo-ovarian abscesses.
Seven of the eight had pelvic masses on imaging studies; one patient had presumed carcinomatosis without an adnexal mass on CT scan. Preoperative CA-125 was elevated in four of the eight patients, with a range of 30.8 to 228 U/mL. All had some form of surgical management with at least one ovary removed.
Clinicians should be aware of this disease to improve diagnosis and direct appropriate patient management.
上皮性卵巢癌通常表现为模糊的症状，导致诊断延迟，直到疾病进展。肉芽肿性腹膜炎是一个用于描述腹腔内肉芽肿性炎症的术语，在临床和影像学上与晚期卵巢癌相似。本研究的目的是在单一机构中检查模仿卵巢癌的肉芽肿性腹膜炎病例的频率和特征，并描述该人群的病因。
确定了8例经病理证实为肉芽肿性疾病且无癌症的病例。病因包括盆腔结核、皮样囊肿破裂、出血性黄体破裂、既往子宫内膜异位症手术、黄色肉芽肿性炎症以及3例输卵管卵巢脓肿。
8例中有7例在影像学检查中有盆腔肿块；1例患者在CT扫描中被推测为癌性腹膜炎，无附件肿块。8例患者中有4例术前CA-125升高，范围为30.8至228 U/mL。所有患者均接受了某种形式的手术治疗，至少切除了一侧卵巢。
临床医生应了解这种疾病，以改善诊断并指导适当的患者管理。
