目的

探讨巨大多房囊性子宫平滑肌瘤的诊断学特征。

方法

结果

患者女性,36 岁,自觉腹部增大2 年余,加重2 个月,伴尿频、腹水及体重增加。 超声检查提示盆腹腔巨大囊实性占位,考虑卵巢恶性肿瘤;右附件区囊性包块,考虑畸胎瘤;子宫浆膜下肌瘤。 盆腹腔增强CT 初步考虑卵巢囊腺癌。 病理诊断为盆腹腔巨大多房囊性平滑肌瘤,最大横径49.2 cm;合并卵巢成熟性囊性畸胎瘤及子宫平滑肌瘤。 经切除后,随访17 个月,无复发。

结论

巨大多房囊性平滑肌瘤以罕见的囊性变为特点,且体积大,依靠影像学检查诊断困难,需要通过组织病理学和免疫组化明确诊断。

Objective

To investigate the diagnostic features of giant multilocular cystic leiomyoma of uterus.

Methods

The clinical data of a newly diagnosed patient with a giant pelvic cavity mass admitted to the Gynecology Department of Shandong Provincial Hospital on August 5, 2023 were collected, and the literature was reviewed to summarize the diagnostic features of giant multilocular cystic leiomyoma.

Results

The patient, a 36-year-old female, had experienced abdominal enlargement for more than 2 years,with worsening symptoms over the past 2 months, accompanied by frequent urination, ascites, and weight gain. Ultrasound examination revealed a large cystic-solid mass in the abdominal pelvic cavity, initially suspected as an ovarian malignancy, and a cystic mass in the right adnexal area, suspected to be a teratoma,and subserous myoma of the uterus. Enhanced CT of the pelvis and abdomen initially suggested ovarian cystadenocarcinoma. The pathological diagnosis was giant multilocular cystic leiomyoma in the pelvic cavity,with a maximum transverse diameter of 49.2 cm, complicated with mature cystic teratoma of the ovary and leiomyoma of the uterus. The patient was followed up for 17 months after resection without recurrence.

Conclusion

Giant multilocular cystic leiomyoma, characterized by rare cystic changes and large size, is difficult to diagnose by imaging examination and needs to be confirmed by histopathology and immunohistochemistry.