青少年卵巢非妊娠期绒毛膜癌误诊一例并文献复习

doi:10.12280/gjfckx.20220768

摘要/Abstract

摘要：

卵巢非妊娠期绒毛膜癌（ovarian non-gestational choriocarcinoma）是一种卵巢生殖细胞起源的罕见恶性肿瘤。人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）升高对本病具有提示作用。青少年常以阴道不规则出血、腹痛就诊，影像学表现为附件区囊实性肿块伴丰富血供。规范治疗对患儿生育功能的保留、生存质量的改善有利。回顾性分析1例青少年卵巢非妊娠期绒毛膜癌误诊病例，分析总结该病的临床特点、病理基础、CT影像学表现及治疗等，以期提高影像科医师对该病的认识，提高术前影像学诊断能力。

关键词: 绒毛膜癌, 非妊娠期, 卵巢, 青少年, 体层摄影术, X线计算机, 误诊

Abstract:

Ovarian non-gestational choriocarcinoma is a rare malignant tumor originating from ovarian germ cell. The increase of human chorionic gonadotropin(hCG) can prompt this disease. Adolescents often see doctors for irregular vaginal bleeding and abdominal pain, imaging findings are cystic mass in adnexal region with abundant blood supply. Standardized treatment is beneficial to the retention of children′s reproductive function and the improvement of their quality of life. This paper aims to make a retrospective analysis of a misdiagnosed case and review the literature, analyze and summarize the clinical features, pathological basis, CT imaging manifestations and treatment of this disease, in order to improve the understanding of the disease among radiologists, improve preoperative imaging diagnosis.

Key words: Choriocarcinoma, non-gestational, Ovary, Adolescent, Tomography, X-ray computed, Diagnostic errors

关红菲, 石丽莉, 李素荣, 程华. 青少年卵巢非妊娠期绒毛膜癌误诊一例并文献复习[J]. 国际妇产科学杂志, 2023, 50(3): 309-312.

GUAN Hong-fei, SHI Li-li, LI Su-rong, CHENG Hua. Misdiagnosis of Ovarian Non-Gestational Choriocarcinoma in Adolescents: A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2023, 50(3): 309-312.

图/表 2

图1 腹部CT图注：A 平扫，轴位，盆腔内形态欠规则的较大肿块，密度不均匀，边界清晰。B 动脉期，轴位，肿块内及左缘见迂曲明显强化的血管。C 静脉期，轴位，肿块强化不均匀，中心呈明显强化，周围部分无明显强化。D 静脉期，冠状面重建，病灶中心部分强化范围较动脉期扩大，其间可见无强化，右侧包膜强化不连续，箭头所指为破裂区。

图2 肿瘤病理图及免疫组织化学图注：A 镜下见由细胞滋养层细胞和合体滋养层细胞混合构成，中心为细胞滋养层细胞，边缘为合体滋养层细胞的排列模式（HE染色×200）；B hCG（SP法×200）。

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