国际妇产科学杂志 ›› 2019, Vol. 46 ›› Issue (4): 394-396.

• 病例报告 • 上一篇    下一篇

子宫平滑肌瘤长入右心腔一例报道

杨琼,谢荣凯,黄强,宋汉香   

  1. 400037 重庆,中国人民解放军陆军军医大学第二附属医院妇产科(杨琼,谢荣凯,黄强),病理科(宋汉香)
  • 收稿日期:2019-01-18 修回日期:2019-04-25 出版日期:2019-08-15 发布日期:2019-08-15
  • 通讯作者: 谢荣凯,E-mail:xrkai@163.com E-mail:xrkai@163.com

Right Atrial Leiomyomatosis: A Case Report

YANG Qiong,XIE Rong-kai,HUANG Qiang,SONG Han-xiang   

  1. Department of Obstetrics and Gynecology(YANG Qiong,XIE Rong-kai,HUANG Qiang),Department of Pathology(SONG Han-xiang),The Second Affiliated Hospital of Army Medical University,Chongqing 400037,China
  • Received:2019-01-18 Revised:2019-04-25 Published:2019-08-15 Online:2019-08-15
  • Contact: XIE Rong-kai,E-mail:xrkai@163.com E-mail:xrkai@163.com

摘要: 子宫平滑肌瘤是女性生殖器官中最常见的良性肿瘤,进入静脉或淋巴管内称为脉管内平滑肌瘤病,局限于子宫可出现月经量增多、经期延长,肿瘤过大压迫可导致下肢肿胀、下腹部不适,累及髂静脉可引起腹痛,肿瘤向上生长累及下腔静脉、右心房、右心室、肺动脉等可出现呼吸困难、心悸、胸痛、胸闷、晕厥等,甚至可出现突发性大出血及休克。报道1例49岁女性患者因子宫平滑肌瘤长入右心腔导致下肢水肿3年,胸闷、胸痛2个月的病例,入院完善检查后予经腹全子宫+双侧附件+盆腔包块切除术,开胸行下腔静脉、右心房、右心室、肺动脉肿物清除术及房间隔缺损修补术,结合术中及病理结果,确诊为子宫平滑肌瘤、血管内平滑肌瘤。好转出院,随访8个月,肿瘤未复发。子宫平滑肌瘤侵入血管长入右心室达肺动脉者极少,病情严重,早发现、早诊断、早治疗尤为重要。

关键词: 平滑肌瘤病, 平滑肌瘤, 子宫, 病例报告

Abstract: Uterine fibroids are the most common benign tumors in female reproductive organs. They are called intravascular leiomyomatosis when they grow into the veins or lymphatic vessels. The menstrual volume can be increased and the menstrual period is prolonged. The excessive tumor compression can cause swelling of the lower limbs. Abdominal discomfort, abdominal pain, difficult breathing, palpitations, chest pain, chest tightness, syncope and other symptoms can occur when the major arteries or veins are involved, there may even be sudden major bleeding and shock. This article described a case of a 49-year-old female patient with uterine leiomyomas growing to the right heart chamber leading to edema of the lower extremities for 3 years, chest tightness and chest pain for 2 months. The total hysterectomy + bilateral oophorosalpingectomy + pelvic mass resection was performed. The mass in the right atrium, right ventricle, pulmonary artery was removal and atrial septal defect was repaired. The pathological findings were uterine leiomyoma and intravascular leiomyoma. After 8 months of follow-up, the tumor did not recur. Uterine leiomyomatosis invading blood vessels into the right atrial and reaching the pulmonary artery is rare. The condition is serious, early detection, early diagnosis and early treatment is particularly important.

Key words: Leiomyomatosis, Leiomyoma, Uterus, Case reports