摘要
目的分析腹膜后肿瘤误诊为妇科肿瘤的原因,提高对腹膜后肿瘤的认识,降低误诊率。方法分析4例误诊为妇科肿瘤的腹膜后肿瘤患者资料、辅助检查、术中特点及病理检查结果,总结误诊原因。结果2例体检发现,1例因腰痛就诊发现,1例因腹胀伴大便困难发现。4例术前行B超检查,3例术前行磁共振成像(MRI)检查,均提示肿瘤来源于附件或阔韧带可能。2例完全切除,2例因肿块基底部与骶前筋膜粘连紧密未完全切除。4例患者病理结果显示,神经节细胞瘤2例,神经鞘瘤1例,良性囊肿伴慢性炎性改变1例。结论腹膜后肿瘤临床症状无特异性,术前诊断困难,特别是位于盆腔的腹膜后肿瘤易被误诊为妇科肿瘤,应通过详细的病史采集及查体、完善辅助检查加以鉴别。超声及MRI对腹膜后肿瘤具有较高的诊断价值,但需提高对本病的认识。
Objective To analyze the causes of retroperitoneal tumor misdiagnosed as gynecological tumor,improve the understanding of retroperitoneal tumor and reduce the rate of misdiagnosis.Methods The data,auxiliary examination,intraoperative characteristics and pathological examination results of 4 patients with retroperitoneal tumor misdiagnosed as gynecological tumor were analyzed,and the causes of misdiagnosis were summarized.Results Two cases were found by physical examination,1 case was found by low back pain,and 1 case was found by abdominal distension with difficulty in defecation.B-ultrasound examination was performed in 4 cases before operation,and magnetic resonance imaging(MRI)examination was performed in 3 cases before operation,all of which suggested that the tumor might be derived from attachment or broad ligament.Complete resection was performed in 2 cases,and incomplete resection was performed in 2 cases due to the tight adhesion between the base of the mass and the presacral fascia.The pathological results of 4 patients showed 2 cases of ganglioneuroma,1 case of schwannoma,and 1 case of benign cyst complicated with chronic inflammatory changes.Conclusion The clinical symptoms of retroperitoneal tumor are not specific,and preoperative diagnosis is difficult.In particular,retroperitoneal tumor located in the pelvic cavity are easily misdiagnosed as gynecological tumor,it should be identified by detailed medical history collection,physical examination and auxiliary examination.Ultrasound and MRI have high diagnostic value for retroperitoneal tumor,but it is necessary to improve the understanding of this disease.
作者
陈若兰
吕朋
牛蔓
黄晓春
马文娟
王君
CHEN Ruolan;LYU Peng;NIU Man;HUANG Xiaochun;MA Wenjuan;WANG Jun(Gynecology and Obstetrics Department,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China;Imaging Center,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China;Pathology Department,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China;Ultrasound Department,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China)
出处
《临床医学研究与实践》
2023年第27期5-8,共4页
Clinical Research and Practice
基金
西安市创新能力强基计划-医学研究项目(No.21YXYJ0048)。
关键词
腹膜后肿瘤
妇科肿瘤
误诊
retroperitoneal tumor
gynecological tumor
misdiagnosis
