外阴巨大血管肌纤维母细胞瘤磁共振成像误诊为脂肪肉瘤一例

doi:10.12280/gjfckx.20230979

国际妇产科学杂志 ›› 2024, Vol. 51 ›› Issue (3): 263-266.doi: 10.12280/gjfckx.20230979

• 妇科肿瘤研究：病例报告 • 上一篇下一篇

外阴巨大血管肌纤维母细胞瘤磁共振成像误诊为脂肪肉瘤一例

马海燕, 张芸中, 郑荣芳, 王芙蓉, 张萌, 郭钰珍()

730000 兰州大学第二临床医学院（马海燕）;兰州大学第二医院妇科（张芸中，郑荣芳，张萌，郭钰珍），病理科（王芙蓉）

收稿日期:2023-11-30 出版日期:2024-06-15 发布日期:2024-06-25
通讯作者: 郭钰珍 E-mail:guoyz@lzu.edu.cn

Giant Angiomyofibroblastoma of the Vulva Misdiagnosed as Liposarcoma on Magnetic Resonance Imaging: A Case Report

MA Hai-yan, ZHANG Yun-zhong, ZHENG Rong-fang, WANG Fu-rong, ZHANG Meng, GUO Yu-zhen()

The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, China (MA Hai-yan); Department of Gynecology (ZHANG Yun-zhong, ZHENG Rong-fang, ZHANG Meng, GUO Yu-zhen), Department of Pathology (WANG Fu-rong), The Second Hospital of Lanzhou University, Lanzhou 730000, China

Received:2023-11-30 Published:2024-06-15 Online:2024-06-25
Contact: GUO Yu-zhen E-mail:guoyz@lzu.edu.cn

摘要/Abstract

摘要：

外阴血管肌纤维母细胞瘤（angiomyofibroblastoma，AMF）是一种育龄期女性罕见的良性肿瘤，起源于女性的外阴或阴道。脂肪肉瘤好发于围绝经期及绝经后女性的躯干、四肢等部位。报道1例外阴巨大AMF磁共振成像（magnetic resonance imaging，MRI）误诊为脂肪肉瘤的病例，该患者因发现外阴肿物3年，增大1年入院，术前MRI诊断为脂肪肉瘤，而术前活检诊断为AMF，行外阴肿物切除术+外阴成形术，术后病理检查诊断AMF，术后随访9个月未见复发。临床医生应加强疾病的鉴别诊断，通过结合术前组织病理学及其相关影像学检查可提高AMF的诊断准确率，为临床提供准确的手术指导信息。

关键词: 血管肌瘤, 肿瘤，肌组织, 外阴, 软组织肿瘤, 脂肪肉瘤, 磁共振成像, 误诊

Abstract:

Vulvar angiomyofibroblastoma (AMF) is a rare benign tumor that occurs in women of childbearing age, originating from the vulva or vagina. Liposarcoma typically occurs in the trunk and limbs of perimenopausal and postmenopausal women. We report a case where a large vulvar AMF was initially misdiagnosed as liposarcoma by magnetic resonance imaging (MRI). The patient who was admitted to the hospital because of the discovery of a vulvar mass for 3 years that had enlarged over one year, was diagnosed with liposarcoma via preoperative MRI. However, a preoperative biopsy revealed AMF. The patient underwent excision of vulvar mass and vulvovaginoplasty. Postoperative pathology confirmed the AMF diagnosis, with no recurrence observed during the postoperative follow up for 9 months. Clinicians should enhance the differential diagnosis of such condition and improve the diagnostic accuracy of AMF by combining preoperative histopathology and related imaging examinations, providing accurate clinical information for surgical guidance.

Key words: Angiomyoma, Neoplasms, muscle tissue, Vulva, Soft tissue neoplasms, Liposarcoma, Magnetic resonance imaging, Diagnostic errors

马海燕, 张芸中, 郑荣芳, 王芙蓉, 张萌, 郭钰珍. 外阴巨大血管肌纤维母细胞瘤磁共振成像误诊为脂肪肉瘤一例[J]. 国际妇产科学杂志, 2024, 51(3): 263-266.

MA Hai-yan, ZHANG Yun-zhong, ZHENG Rong-fang, WANG Fu-rong, ZHANG Meng, GUO Yu-zhen. Giant Angiomyofibroblastoma of the Vulva Misdiagnosed as Liposarcoma on Magnetic Resonance Imaging: A Case Report[J]. Journal of International Obstetrics and Gynecology, 2024, 51(3): 263-266.

图/表 4

图1 外阴肿物肉眼观及MRI图注：A肿物大小20 cm×15 cm；B盆腔MRI平扫，箭头所示为肿物；C盆腔MRI增强扫描呈不均匀强化，如箭头所示。

图2 外阴肿物病理及免疫组织化学图注：A术前活检病理图（HE×400），红色箭头所示为脂肪细胞，黑色箭头所示为纤维母细胞；B Desmin（+）（免疫组织化学染色×400）；C ER（+）（免疫组织化学染色×400）。标尺=50 μm。

图3 术中标本图

图4 术后病理图（HE×200）注：红色箭头所示为脂肪细胞，黑色箭头所示为纤维母细胞。标尺=100 μm。

参考文献 15

[1]	贾荣霞, 周旭, 石贽堃, 等. 外阴血管肌纤维母细胞瘤复发1例报告及文献复习[J]. 吉林大学学报(医学版), 2023, 49(1):193-197. doi: 10.13481/j.1671-587X.20230125.
[2]	Anggraeni TD, Nuranna L, Luthfiyanto M, et al. Rare case of huge vulvar angiomyofibroblastoma in a young female[J]. Gynecol Oncol Rep, 2021,36:100751. doi: 10.1016/j.gore.2021.100751.
[3]	Haddox CL, Riedel RF. Recent advances in the understanding and management of liposarcoma[J]. Fac Rev, 2021,10:1. doi: 10.12703/r/10-1.
[4]	Peng R, Li N, Lan T, et al. Liposarcoma in children and young adults: a clinicopathologic and molecular study of 23 cases in one of the largest institutions of China[J]. Virchows Arch, 2021, 479(3):537-549. doi: 10.1007/s00428-021-03076-8.
[5]	Fletcher CD, Tsang WY, Fisher C, et al. Angiomyofibroblastoma of the vulva. A benign neoplasm distinct from aggressive angiomyxoma[J]. Am J Surg Pathol, 1992, 16(4):373-382. doi: 10.1097/00000478-199204000-00006. pmid: 1314521
[6]	Kanda M, Sonoyama A, Hirano H, et al. Angiomyofibroblastoma of the vulva[J]. Eur J Gynaecol Oncol, 2014, 35(1):77-80. pmid: 24654468
[7]	Choi JH, Ro JY. The 2020 WHO Classification of Tumors of Soft Tissue: Selected Changes and New Entities[J]. Adv Anat Pathol, 2021, 28(1):44-58. doi: 10.1097/PAP.0000000000000284.
[8]	Johnson CN, Ha AS, Chen E, et al. Lipomatous Soft-tissue Tumors[J]. J Am Acad Orthop Surg, 2018, 26(22):779-788. doi: 10.5435/JAAOS-D-17-00045. pmid: 30192249
[9]	徐红, 杨太珠, 庞厚清, 等. 女性外阴血管肌纤维母细胞瘤超声表现1例[J]. 中国介入影像与治疗学, 2016, 13(12):719. doi: 10.13929/j.1672-8475.2016.12.002.
[10]	霍媛媛, 郝向云, 张桃桃, 等. 血管肌纤维母细胞瘤临床病理分析[J]. 现代肿瘤医学, 2021, 29(6):1009-1012. doi: 10.3969/j.issn.1672-4992.2021.06.022.
[11]	徐又先, 陈柏秀. 阴道侧壁血管肌纤维母细胞瘤1例[J]. 实用妇产科杂志, 2013, 29(11):877.
[12]	Gibbs J, Henderson-Jackson E, Bui MM. Bone and Soft Tissue Pathology: Diagnostic and Prognostic Implications[J]. Surg Clin North Am, 2016, 96(5):915-962. doi: 10.1016/j.suc.2016.06.003. pmid: 27542635
[13]	丁洪基, 高淑红, 孔翔, 等. 血管肌纤维母细胞瘤2例临床病理分析[J]. 临床与实验病理学杂志, 2016, 32(11):1276-1277,1280. doi: 10.13315/j.cnki.cjcep.2016.11.021.
[14]	化宏金, 司海鹏, 潘敏鸿, 等. 伴炎症性恶性纤维组织细胞瘤样形态学特征的去分化脂肪肉瘤7例临床病理特征[J]. 临床与实验病理学杂志, 2023, 39(10):1212-1216. doi: 10.13315/j.cnki.cjcep.2023.10.013.
[15]	Qiu P, Wang Z, Li Y, et al. Giant pelvic angiomyofibroblastoma: case report and literature review[J]. Diagn Pathol, 2014,9:106. doi: 10.1186/1746-1596-9-106.

外阴巨大血管肌纤维母细胞瘤磁共振成像误诊为脂肪肉瘤一例

Giant Angiomyofibroblastoma of the Vulva Misdiagnosed as Liposarcoma on Magnetic Resonance Imaging: A Case Report

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 15

相关文章 15

编辑推荐

Metrics

本文评价

[1]	宋翰, 刘晗黎, 王希波. 宫颈癌背部软组织转移一例[J]. 国际妇产科学杂志, 2024, 51(6): 672-675.
[2]	李慧敏, 胡雅莉, 张森淮, 马晓梅, 许飞雪. 高强度聚焦超声技术在妇产科疾病中的应用进展[J]. 国际妇产科学杂志, 2024, 51(5): 486-491.
[3]	刘彦君, 张颖. 大量腹水合并CA125升高的寄生性平滑肌瘤一例[J]. 国际妇产科学杂志, 2024, 51(5): 588-592.
[4]	何玉如, 夏革清. 单绒毛膜双胎之一胎死宫内存活胎脑损伤的研究进展[J]. 国际妇产科学杂志, 2024, 51(4): 458-462.
[5]	王芳芳, 赵会海, 吴洋, 孙莉. 妊娠期外阴阴道假丝酵母菌病患者烯醇化酶含量与妊娠结局的关系[J]. 国际妇产科学杂志, 2024, 51(4): 468-472.
[6]	刘思敏, 魏佳, 万怡, 李钰滋, 杨永秀. 外阴棘层松解型鳞状细胞癌一例[J]. 国际妇产科学杂志, 2024, 51(3): 267-270.
[7]	杨祎, 刘华. 误诊为卵巢肿瘤的结肠侵袭性纤维瘤病一例[J]. 国际妇产科学杂志, 2024, 51(3): 271-273.
[8]	王晓利, 陈屹, 郑新春, 曹艳花. 不典型子宫附腔畸形一例[J]. 国际妇产科学杂志, 2024, 51(2): 148-151.
[9]	姜龙环, 褚春玉, 张营, 朱彤宇. 妊娠剧吐合并韦尼克脑病一例[J]. 国际妇产科学杂志, 2024, 51(2): 194-197.
[10]	盖敏雪, 王洪庆, 王玉佳, 李玲玲, 李长忠. 晚期上皮性卵巢癌误诊为盆腔结核一例[J]. 国际妇产科学杂志, 2024, 51(1): 78-81.
[11]	周畅, 段华, 郭银树, 何春燕. 外阴孤立性纤维性肿瘤一例并文献复习[J]. 国际妇产科学杂志, 2023, 50(6): 660-664.
[12]	马帅, 徐影, 王敏, 李杰. 胎儿颅内出血的研究进展[J]. 国际妇产科学杂志, 2023, 50(5): 481-485.
[13]	丁懿, 高峻, 李文燕, 叶丹, 马振琴, 何荣霞. 全子宫切除术后阴道残端血管平滑肌瘤一例[J]. 国际妇产科学杂志, 2023, 50(5): 594-596.
[14]	席欣欣, 张林凤, 李佳. 子宫乳腺型肌纤维母细胞瘤一例并文献复习[J]. 国际妇产科学杂志, 2023, 50(4): 396-399.
[15]	许阡, 成九梅. 误诊为妇科肿瘤的58例临床病例分析[J]. 国际妇产科学杂志, 2023, 50(3): 297-301.