妊娠期异常生殖细胞瘤

Ivana Likić-Lađević, Katarina Stefanović, Branislav Milošević, Igor Pilić, Zoran Vilendečić, Jelena Stojnić, Aleksandra Beleslin, Olga Mihaljević, Jelena Dotlić
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摘要

恶性生殖细胞肿瘤(mgct)是一种罕见的非上皮性卵巢癌(NOEC)亚型,最常见于妊娠期。在所有mgct中,38%为生殖细胞异常瘤。考虑到这些实体的罕见性,本文的目的是显示一个罕见的卵巢异常生殖细胞瘤出现在妊娠及其对妊娠过程和结局的影响。患者回顾:患者年龄26岁,妊娠2期,第1段,5年前阴道分娩1次,因子宫收缩伴左大腿疼痛,左腿刺痛感,足月妊娠入住妇产科门诊。超声示子宫左侧相邻实性低回声肿块,边界规则,直径125x90mm,盆腔内无游离液体。由于正常的子宫收缩开始,由于肿瘤前置,决定通过剖腹产(CS)终止妊娠。组织病理检查证实为卵巢异常生殖细胞瘤,CS术后2个月行分期手术,影像学诊断为FIGO IA期卵巢异常生殖细胞瘤,患者特异性肿瘤治疗结束。结论:卵巢异常生殖细胞瘤的诊断通常具有挑战性,因为高达50%的患者无症状或症状非特异性。妊娠期卵巢癌的管理应多学科和个性化的母亲和胎儿的最大利益。卵巢异常生殖细胞瘤的总体5年生存率在90%以上的病例中是有利的。在怀孕期间诊断为生殖细胞异常瘤的妇女年轻,通常有良好的胎母结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dysgerminoma in pregnancy
Introduction: Malignant germ cell tumors (MGCTs), as a subtype of rare non-epithelial ovarian cancers (NOEC), are most commonly found in pregnancy. Of all MGCTs, 38% are dysgerminoma. Considering the rarity of these entities, the aim of this paper is to show a rare case of ovarian dysgerminoma presented in pregnancy and its influence on course and outcome of the pregnancy. Patient Review: Patient aged 26, gravida 2, para 1, with one vaginal delivery five years before, was admitted to the Clinic for Gynecology and obstetrics in term pregnancy because of uterine contractions accompanied by left thigh pain and tingling sensation in the left leg. Solid hypoechogenic mass with regular borders, 125x90 mm in diameter adjacent to the left side of the uterus was seen by ultrasound, without free fluid in pelvic cavity. Since regular uterine contractions started, the decision was made to terminate pregnancy by Caesarean section (CS) because of tumor previa. Histopathological examination confirmed ovarian dysgerminoma, but after staging operation which was performed two months after CS, following imaging diagnostics, ovarian dysgerminoma was confirmed with FIGO stage IA, meaning that patient's specific oncological treatment was finished. Conclusion: Diagnosis of ovarian dysgerminoma is in general challenging since up to 50% are asymptomatic or symptoms are non-specific. The management of ovarian cancer in pregnancy should be multidisciplinary and individualized in the best interest of the mother and the fetus. The overall five-year survival rate for ovarian dysgerminoma is favorable in more than 90% of cases. Women diagnosed with dysgerminoma in pregnancy are young and in general have good feto-maternal outcome.
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