一例罕见的卵巢淋巴管瘤合并乳糜性腹水并升高CA-125。

IF 0.4 Q4 OBSTETRICS & GYNECOLOGY
M. Mangla
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引用次数: 0

摘要

淋巴管瘤是淋巴系统的良性先天性畸形,被认为是由于局部淋巴流系统阻塞而发生的。它们可以发生在皮肤和粘膜的任何地方。最常见的部位是头部和颈部,但有时也可以在肠道、胰腺和肠系膜中找到。卵巢淋巴管瘤是一种极为罕见的病变。它于1908年首次被描述。临床表现从无症状的卵巢肿块到急腹症不等。它们可能经常与卵巢恶性肿块混淆,通常导致大面积手术。一名34岁的女性在过去6个月内表现为下腹部隐痛。超声和腹部CECT提示右卵巢增大伴大量腹水。Ca-125为685。腹腔镜诊断显示乳糜腹水,冷冻切片显示少数非典型细胞,进一步加强了对恶性肿瘤的诊断。最后进行了分期剖腹手术,包括全腹子宫切除术和输卵管卵巢切除术。组织病理学显示淋巴管瘤,没有恶性肿瘤的证据。CA-125在手术后也表现出快速下降。淋巴管瘤应纳入卵巢囊性肿块的鉴别诊断,尤其是乳糜性腹水患者。为了避免过度治疗,将此类病例与其他恶性肿瘤区分开来是非常重要的。然而,卵巢淋巴管瘤患者需要仔细随访至少2年,以排除复发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A rare case of ovarian Lymphangioma associated with chylous ascites and raised CA-125.
Lymphangiomas are benign congenital malformations of lymphatic system, thought to happen due to obstruction of local lymph flow system. They can occur anywhere in the skin and the mucous membranes. Most common sites are the head and the neck but sometimes, they can be found in the intestines, the pancreas and the mesentery. Lymphangioma of the ovary is an extremely rare lesion. It was first described in 1908. Clinical manifestations can vary from asymptomatic ovarian mass to acute abdomen. They may be very frequently confused with malignant ovarian mass often leading to extensive surgery. A 34-year-old female presented with dull aching pain localized to lower abdomen from last 6 months. Ultrasound and CECT abdomen were suggestive of enlarged right ovary with massive ascites. Ca-125 was 685. Diagnostic laparoscopy revealed chylous ascites and further a frozen section revealed few atypical cells, further strengthening the diagnosis of malignant tumor. Staging laparotomy with total abdominal hysterectomy and salpingo-oophorectomy was finally done. Histopathology revealed lymphangioma, with no evidence of malignancy. CA-125 also showed a rapid decline following surgery. Lymphangiomas should be included in the differential diagnosis of ovarian cystic masses, especially in patients with chylous ascites. It is very important to discriminate such cases from other malignant tumors in order to avoid overtreatment. However, a careful follow up for at least 2 years is needed for patients with lymphangioma of the ovary in order to exclude recurrence.
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来源期刊
South African Journal of Obstetrics and Gynaecology
South African Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
5
审稿时长
15 weeks
期刊介绍: The SAJOG is a tri-annual, general specialist obstetrics and gynaecology journal that publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. The journal carries original research articles, editorials, clinical practice, personal opinion, South Africa health-related news, obituaries and general correspondence.
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