子宫间皮囊肿误诊肌瘤囊性变一例

doi:10.12280/gjfckx.20211101

国际妇产科学杂志 ›› 2022, Vol. 49 ›› Issue (5): 556-559.doi: 10.12280/gjfckx.20211101

• 妇科肿瘤研究:病例报告 • 上一篇下一篇

子宫间皮囊肿误诊肌瘤囊性变一例

朱姝¹^,², 张会媛¹^,², 徐炜¹^,², 王聪¹^,², 王秀丽¹^,²()

210036 江苏省人民医院（南京医科大学第一附属医院）妇科（朱姝,徐炜,王秀丽）,病理科（王聪）；南京医科大学第一临床医学院妇产科学系（张会媛）

收稿日期:2021-11-29 出版日期:2022-10-15 发布日期:2022-10-24
通讯作者: 王秀丽 E-mail:xiuli_2266@163.com
基金资助:
江苏省妇幼健康重点人才课题(FRC201709)

A Case of Uterine Mesothelial Cyst Misdiagnosed as Leiomyoma with Cystic Degeneration

ZHU Shu¹^,², ZHANG Hui-yuan¹^,², XU Wei¹^,², WANG Cong¹^,², WANG Xiu-li¹^,²()

Department of Gynecology (ZHU Shu, XU Wei, WANG Xiu-li), Department of Pathology (WANG Cong), Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University), Nanjing 210036, China; Department of Obstetrics and Gynecology, The First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China (ZHANG Hui-yuan)

Received:2021-11-29 Published:2022-10-15 Online:2022-10-24
Contact: WANG Xiu-li E-mail:xiuli_2266@163.com

摘要/Abstract

摘要：

间皮囊肿是来源于间皮细胞的一种良性肿瘤性病变,主要累及盆腹腔腹膜,以肠系膜及大网膜多见,较少发生于子宫。报告南京医科大学第一附属医院收治的1例子宫间皮囊肿患者误诊为子宫肌瘤囊性变的诊治经过。该患者术前无典型临床表现,主要依据影像学特点诊断为子宫肌瘤囊性变并进行全子宫+双侧输卵管切除术,术后病理确诊为子宫间皮囊肿。通过回顾分析该患者的诊治经过并结合文献复习,探讨子宫间皮囊肿的鉴别诊断及治疗方式,以期提高妇科医生对该疾病的认识,避免误诊和漏诊。

关键词: 子宫肿瘤, 平滑肌瘤, 间皮瘤,囊性, 诊断, 治疗, 预后

Abstract:

Mesothelial cyst is a benign neoplastic lesion derived from mesothelial cells, mainly involves pelvic peritoneum and peritoneal peritoneum. It is more common in mesentery and omentum majus, and less in uterus. This paper reports the diagnosis and management of a patient with uterine mesothelial cyst misdiagnosed as leiomyoma with cystic degeneration in the First Affiliated Hospital of Nanjing Medical University. This patient with no typical clinical manifestations preoperatively was diagnosed as leiomyoma with cystic degeneration and underwent total hysterectomy and bilateral salpingo-oophorectomy, mainly based on imaging characteristics. But the postoperative pathology, indicated uterine mesothelial cyst. This paper analyzes the diagnosis and treatment of the patient and reviews relevant literature, discuss the differential diagnosis and treatment of uterine mesothelial cyst, in order to improve the academic vision of the disease in gynecologists and avoid misdiagnosis and underdiagnosis.

Key words: Uterine neoplasms, Leiomyoma, Mesothelioma, cystic, Dagnosis, Therapy, Prognosis

朱姝, 张会媛, 徐炜, 王聪, 王秀丽. 子宫间皮囊肿误诊肌瘤囊性变一例[J]. 国际妇产科学杂志, 2022, 49(5): 556-559.

ZHU Shu, ZHANG Hui-yuan, XU Wei, WANG Cong, WANG Xiu-li. A Case of Uterine Mesothelial Cyst Misdiagnosed as Leiomyoma with Cystic Degeneration[J]. Journal of International Obstetrics and Gynecology, 2022, 49(5): 556-559.

图/表 6

表1 2010年6月—2021年3月我院收治的间皮囊肿患者发病部位

发病部位	例数（例）	占比（%）	男（例）	女（例）	年龄（岁）
附件	12	40.0	0	12	48±20
胸腔纵隔	5	16.7	2	3	55±18
子宫	4	13.3	0	4	44±8
腹腔-来源不明确	4	13.3	2	2	45±2
盆腔-来源不明确	3	10.0	1	2	42±17
大网膜	1	3.3	0	1	47
膀胱	1	3.3	0	1	34
合计	30	100.0	5	25	47±16

图1 子宫间皮囊肿B超图像

图2 子宫间皮囊肿MRI图像

图3 子宫间皮囊肿术中探查

图4 子宫标本沿后壁纵向切开剖视图

图5 HE及免疫组织化学染色图片注：A HE×40,B HE×200,C HE×400,箭头所示为囊壁内覆衬单层立方形间皮细胞。D 囊壁被覆上皮间皮细胞呈阳性（SP法×200）,E 囊壁被覆上皮D2-40呈阳性（SP法×200）,箭头所示为囊壁被覆上皮免疫标志处。

参考文献 15

[1]	Mishra A, Malik S, Agarwal K, et al. Benign Cystic Mesothelioma of Uterus: An Unusual Cause of Pelvic Pain[J]. J Obstet Gynaecol India, 2016, 66(Suppl 2):720-722. doi: 10.1007/s13224-016-0917-8. doi: 10.1007/s13224-016-0917-8
[2]	Mo SP, Wang MY, Li JK. Mesothelial cyst of uterine corpus misdiagnosed as leiomyoma[J]. Chin Med J (Engl), 2019, 132(12):1502-1503. doi: 10.1097/CM9.0000000000000291. doi: 10.1097/CM9.0000000000000291
[3]	李琛, 李龙, 冀静, 等. 子宫阔韧带内良性间皮囊肿一例[J]. 国际妇产科学杂志, 2015, 42(6):642-643.
[4]	闵洁, 聂秀, 赵虹, 等. 子宫浆膜下间皮囊肿误诊附件包块的临床分析[J]. 华中科技大学学报(医学版), 2004, 33(5):649. doi: 10.3870/j.issn.1672-0741.2004.05.041. doi: 10.3870/j.issn.1672-0741.2004.05.041
[5]	孙玉洁, 李怀芳. 子宫浆膜下间皮囊肿一例[J]. 国际妇产科学杂志, 2014, 41(1):85-86.
[6]	武忠弼, 杨光华. 中华外科病理学[M]. 北京: 人民卫生出版社, 2002:971-973.
[7]	WHO Classification of Tumours Editorial Board. WHO classification of tumours. Soft tissue and bone tumours[M]. 5th ed. Lyon: IARC Press, 2020.
[8]	WHO Classification of Tumours Editorial Board. WHO classification of tumours. Female Genital Tumours[M]. 5th ed. Lyon: IARC Press, 2020.
[9]	Kurisu Y, Tsuji M, Shibayama Y, et al. Multicystic mesothelioma caused by endometriosis: 2 case reports and review of the literature[J]. Int J Gynecol Pathol, 2011, 30(2):163-166. doi: 10.1097/PGP.0b013e3181f99def. doi: 10.1097/PGP.0b013e3181f99def pmid: 21293283
[10]	吴强乐, 林俊, 唐栋. 磁共振DWI联合ADC对子宫肉瘤和变性子宫肌瘤的诊断价值[J]. 重庆医学, 2019, 48(14):2419-2422. doi: 10.3969/j.issn.1671-8348.2019.14.019. doi: 10.3969/j.issn.1671-8348.2019.14.019
[11]	Kim TH, Kim JW, Kim SY, et al. What MRI features suspect malignant pure mesenchymal uterine tumors rather than uterine leiomyoma with cystic degeneration?[J]. J Gynecol Oncol, 2018, 29(3):e26. doi: 10.3802/jgo.2018.29.e26. doi: 10.3802/jgo.2018.29.e26
[12]	Pitta X, Andreadis E, Ekonomou A, et al. Benign multicystic peritoneal mesothelioma: a case report[J]. J Med Case Rep, 2010, 4:385. doi: 10.1186/1752-1947-4-385. doi: 10.1186/1752-1947-4-385
[13]	Cavallaro A, Berretta M, Lo Menzo E, et al. Cystic peritoneal mesothelioma: report of a case[J]. Surg Today, 2011, 41(1):141-146. doi: 10.1007/s00595-010-4301-5. doi: 10.1007/s00595-010-4301-5 pmid: 21191708
[14]	Manatakis DK, Stamos N, Agalianos C, et al. Mesothelial cyst of the round ligament misdiagnosed as irreducible inguinal hernia[J]. Case Rep Surg, 2013, 2013:408078. doi: 10.1155/2013/408078. doi: 10.1155/2013/408078
[15]	Karpathiou G, Casteillo F, Dridi M, et al. Mesothelial Cysts[J]. Am J Clin Pathol, 2021, 155(6):853-862. doi: 10.1093/ajcp/aqaa189. doi: 10.1093/ajcp/aqaa189 pmid: 33258870

子宫间皮囊肿误诊肌瘤囊性变一例

A Case of Uterine Mesothelial Cyst Misdiagnosed as Leiomyoma with Cystic Degeneration

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