病例报告-一个不寻常的腹膜子宫内膜异位症植入物

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摘要

子宫内膜异位症定义为子宫腔外子宫内膜组织异位。浅表性腹膜子宫内膜异位症的特征是小的浅表病变,由白色变为深棕色。尺寸从几毫米到3厘米不等。我们报告一例38岁的患者,直到妇科检查前5 - 6个月,当痛经相关的深度性交困难出现时,才在妇科病理上有意义。临床和超声检查显示盆腔囊性病变,直径约5厘米,首次诊断为左卵巢子宫内膜异位囊肿。骨盆囊性病变经腹腔镜检查证实。实际上这是一个大的腹膜植入物(左侧卵巢完全正常)。病理报告证实,病变的一个组成部分有结节的华丽子宫内膜异位症。卵巢皮层不存在,但肯定有反应性间皮:检查组织必须诊断为腹膜子宫内膜异位症植入。结论:我们报告一例迟发性腹膜子宫内膜异位症患者,其尺寸异常(直径5cm),患者仅在诊断前6个月有特殊症状
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Case Report -An Unusual Peritoneal Endometriotic Implant
Endometriosis is defined as ectopic presence of endometrial tissue outside of uterine cavity. Superficial peritoneal endometriosis is characterized by small superficial lesions modifying from white to dark brown shades. Dimension goes from few millimetres to 3 centimetres. We report a case of a 38 years old patient who has not had a signification in gynaecological pathology until five-six months before the gynecological check, when dysmenorrhea conditions associated at depth dyspareunia arose. Clinical and ultrasound investigations showed the presence of a pelvic cystic lesion, around 5 cm in diameter, diagnosed in the first instance as endometriotic cyst of the left ovary. The cystic lesion in the pelvis was confirmed by laparoscopic inspection. Really it was a large peritoneal implant (the left ovary was perfectly normal). The pathological report confirmed that a component of the lesion had nodules of florid endometriosis. It doesn’t exist ovarian cortex, but definitely a responsive mesothelium: the examined tissue has to be diagnosed with peritoneal endometriotic implant. Conclusions We refer to a case of peritoneal endometriotic implantation that has unusual dimensions (5 cm in diameter) late-onset in a woman who has experienced a specific symptomatology only in the last 6 months before the diagnosis
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