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腹腔镜下切除巨大肠系膜后卵巢浆液性黏液性囊腺瘤:病例报告及文献复习

Laparoscopic resection of a giant post-mesenteric ovarian seromucinous cystadenoma: a case report and review.

作者信息

Chen Hong, Ye Yifan, Liu He, Huang Rui, Li Ningbo, Tang Yaling

机构信息

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China.

Department of Clinical Medicine, School of Medicine, Fujian Medical University, Fuzhou, China.

出版信息

Front Oncol. 2025 Jun 12;15:1576522. doi: 10.3389/fonc.2025.1576522. eCollection 2025.

Abstract

BACKGROUND

Ovarian seromucinous tumors represent a rare subclass of ovarian neoplasms. While the majority of these tumors are benign, the potential for malignant transformation persists and should be considered. To enhance patient outcome and mitigate the risk, early detection and timely intervention are paramount. In cases involving large or complex ovarian masses, open surgery is often the preferred approach, as it provides superior access for comprehensive tumor resection and enables immediate histopathological evaluation. Nevertheless, with advancements in laparoscopic techniques, single-port laparoscopic surgery has emerged as a viable alternative for patients. This approach not only demonstrates comparable effectiveness but also offers the benefits of expedited recovery and reduced scarring.

CASE REPORT

A 65-year-old female presented with a seven-month history of abdominal distension, a sensation of fullness beneath the xiphoid, left-sided discomfort, and intermittent morning cramping. Laboratory findings revealed a mild elevation in CA-125 to 46 U/mL, and CT imaging suggested a diagnosis of an ovarian cystadenoma or possibly a retroperitoneal mass. Preoperative assessment was challenging due to the tumor's irregular morphology, substantial size, and its adhesions to surrounding pelvic and abdominal structures, making it difficult to precisely determine its origin. In light of these complexities, a single-port laparoscopic approach was chosen to minimize trauma, allow for more precise handling of the tumor, and reduce the risk of cystic fluid leakage or inadvertent dissemination of the tumor. Postoperative pathological examination confirmed the lesion to be a seromucinous ovarian cystadenoma.

CONCLUSION

This case exemplifies the imperative for a multidisciplinary approach in the diagnosis and treatment of ovarian seromucinous tumors, emphasizing the advantages of minimally invasive surgical techniques. Given the rarity of such tumors, it is essential that ongoing research into the pathogenesis, classification, and treatment strategies be prioritized to enhance patient outcomes.

摘要

背景

卵巢浆液性黏液性肿瘤是卵巢肿瘤中一个罕见的亚类。虽然这些肿瘤大多数是良性的,但仍存在恶变的可能性,应予以考虑。为提高患者预后并降低风险,早期发现和及时干预至关重要。在涉及大型或复杂卵巢肿块的病例中,开放手术通常是首选方法,因为它为全面肿瘤切除提供了更好的入路,并能立即进行组织病理学评估。然而,随着腹腔镜技术的进步,单孔腹腔镜手术已成为患者的一种可行替代方案。这种方法不仅显示出相当的有效性,还具有恢复快和疤痕少的优点。

病例报告

一名65岁女性,有7个月的腹胀病史,剑突下有饱腹感、左侧不适和间歇性晨起绞痛。实验室检查结果显示CA-125轻度升高至46 U/mL,CT成像提示诊断为卵巢囊腺瘤或可能是腹膜后肿块。由于肿瘤形态不规则、体积大且与周围盆腔和腹部结构粘连,术前评估具有挑战性,难以精确确定其起源。鉴于这些复杂性,选择了单孔腹腔镜手术方法,以尽量减少创伤,更精确地处理肿瘤,并降低囊液泄漏或肿瘤意外播散的风险。术后病理检查证实病变为浆液性黏液性卵巢囊腺瘤。

结论

本病例体现了卵巢浆液性黏液性肿瘤诊断和治疗中多学科方法的必要性,强调了微创外科技术的优势。鉴于此类肿瘤的罕见性,必须优先对其发病机制、分类和治疗策略进行持续研究,以提高患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23e6/12198123/781774155ae5/fonc-15-1576522-g001.jpg

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