妊娠合并卵巢肿瘤36例临床诊治体会

通过对36例妊娠合并卵巢肿瘤临床资料回顾分析，探讨了妊娠与卵巢肿瘤之间关系，介绍了妊娠合并卵巢肿瘤的诊断与治疗方法。     

妊娠合并卵巢肿瘤33例临床分析

妊娠合并卵巢肿瘤并不少见 ,对妊娠和分娩均会产生一定影响 ,处理不当会危及母儿生命。本文分析 11年我院医治的妊娠合并卵巢肿瘤患者 33例 ,探讨其诊断及治疗方法如下 :1　临床资料1.1　一般资料　 1990年 3月至 2 0 0 1年 3月在我院分娩者共 5 0 4 2例 ,同期诊治妊娠合并卵巢肿瘤患者 33例 ,发生率 0 6 5 % ,年龄 18～ 38岁 ,孕次 2～ 6次 ,卵巢肿瘤发生在单侧 2 6例、双侧 7例。1.2　诊断方式及时间　 33例妊娠合并卵巢肿瘤的诊断方式及时间见表 1。 7例于孕前诊断 ,15例早孕时诊断 ,5例中妊诊断 ,晚妊Ｂ超发现 1例 ,5例剖宫产时发现。…     

卵巢癌肉瘤4例报告

卵巢癌肉瘤临床上罕见 ,恶性程度高 ,预后极差。目前手术和化疗是治疗的主要手段 ,令人遗憾的是化疗效果较差 ,患者多在发病后 1年内死亡。我院 1980年 1月 1日至 2 0 0 0年 6月 2 0日收治卵巢癌肉瘤 4例 ,现报告如下。1　病例报告例 1.5 8岁 ,绝经 11年 ,下腹胀 3个月于 1984年 6月 5日入院。患者Ｇ 4Ｐ3 ,体格检查 :消瘦 ,腹部膨胀 ,腹腔积液征 ( ) ,盆腔肿块 12ｃｍ× 10ｃｍ× 9ｃｍ大小 ,囊实性 ,表面凹凸不平 ,周围境界不清。Ｂ超检查 :右侧卵巢大小为 8ｃｍ× 7ｃｍ× 6ｃｍ ,囊实性 ,腹腔积液。入院诊断为卵巢肿瘤 ,于 1984年 6…     

妊娠合并卵巢肿瘤112例分析

 目的 明确妊娠合并卵巢肿瘤的诊断和处理。方法 对1995年1月至2006年12月112例妊娠合并卵巢肿瘤患者的临床资料进行回顾性分析。结果 妊娠合并卵巢肿瘤以成熟畸胎瘤最多，占34.8 %，妊娠合并卵巢肿瘤的扭转率为15.2 %，卵巢恶性肿瘤的发生率为1.8 %。结论 加强产前检查，可及早发现妊娠合并卵巢肿瘤，防止并发症，选择适宜的手术时机及手术方式。     

妊娠合并卵巢肿瘤的临床分析

探讨临床治疗妊娠合并卵巢肿瘤的有效方式,并对治疗效果进行研究分析。方法：选取2008年4月至2011年4月,3年间于本院确诊为妊娠期合并卵巢肿瘤患者232例,回顾其临床资料并进行比较分析。结果：妊娠合并卵巢肿瘤患者发生率为0.61%,孕前发现12例,孕早期发现63例,孕中期发现32例,孕晚期发现125例,其中良性肿瘤225例,交界性肿瘤1例,恶性肿瘤6例,以成熟性畸胎瘤和浆液性囊腺瘤为主,共发生并发症66例,以卵巢肿瘤蒂扭转（69.70%）为主,手术治疗209例,卵巢肿瘤自然消失13例,自然分娩10例。结论：妊娠合并卵巢肿瘤以良性肿瘤为主,手术时机及术式主要取决于卵巢肿瘤的大小、位置、形态、性质、孕期及患者的要求等。     

妊娠合并卵巢肿瘤的诊断及处理

卵巢肿瘤是妊娠期较常见的并发症之一，其发生率文献报道差异较大，为0．7％～0．0007％，其中卵巢良性肿瘤占95％～98％，而恶性肿瘤只占2％～5％。近年发生率有明显上升趋势，估计与产前妇科检查和孕期B超检查的广泛开展以及剖宫产率上升致剖宫产术中发现增多有关。妊娠合并卵巢肿瘤的危害性远较非妊娠期大，治疗时需要兼顾母儿两方面因素，故诊断与处理也尤为重要。     

妊娠合并卵巢肿瘤和子宫肌瘤的临床诊断及治疗

目的:分析妊娠合并卵巢肿瘤和子宫肌瘤的临床特征、诊断及其治疗。方法:回顾性分析2010年1月-2012年8月我院产科妊娠合并卵巢肿瘤59例、妊娠合并子宫肌瘤（肌瘤直径大于4cm）患者265例临床资料,分析妊娠合并卵巢肿瘤、妊娠合并子宫肌瘤患者的临床资料、诊断时间、治疗等。结果:妊娠合并卵巢肿瘤患者平均孕次以及无临床自觉症状百分率显著高于妊娠合并子宫肌瘤患者（P＜0.05）;妊娠合并卵巢肿瘤患者彩超诊断准确率89.83%,妊娠合并子宫肌瘤患者彩超诊断准确率为85.28%,两组比较,差异无统计学意义（P＞0.05）;在59例妊娠合并卵巢肿瘤患者中,53例行剖宫产,剖宫产术中同时实施手术患者53例,占剖宫产人数的100.00%,实施卵巢肿瘤剥除加卵巢成形术患者43例（81.13%）、行患侧附件切除术患者10例（18.87%）;在265例妊娠合并子宫肌瘤患者中,164例行剖宫产,剖宫产术中同时行肌瘤剔除术患者135例,占剖宫产人数的82.32%。结论:妊娠合并卵巢肿瘤患者无明显的临床症状;彩超诊断对与妊娠合并卵巢肿瘤、妊娠合并子宫肌瘤具有着重要的应用价值;在严格控制患者病情、掌握手术指征的情况下,剖宫产同时行手术治疗是一种良好的治疗方式。     

妊娠合并卵巢肿瘤的临床诊断和妊娠结局分析

目的:探讨妊娠合并卵巢肿瘤的临床诊断和妊娠结局,总结预防感染措施。方法:随机选取2011年2月-2013年4月75例妊娠合并卵巢肿瘤患者为研究对象,作为观察组,同时期的75例妊娠合并瘤样病变患者为对照组。从临床表现、辅助检查上比较妊娠合并卵巢肿瘤患者临床特征,并分析其妊娠结局,观察采取预防感染措施后感染发生情况。结果:妊娠合并卵巢肿瘤通常无明显的临床症状,有症状则以恶心呕吐、腹痛等为主。和瘤样病变比较,其肿瘤直径增大明显,肿瘤血流阻力指数下降,孕期肿块均较瘤样病变明显。观察组CA125增高46例,平均值为（31.53±14.73）U/ml,对照组CA125增高41例,平均值为（29.27±12.23）U/ml,两组比较无明显差异性（P>0.05）。两组患者CA199、CEA、AFP检测结果比较差异无统计学意义,均在正常范围内。妊娠合并卵巢肿瘤的妊娠结局以足月产为主,占全部的74.67%,早产和流产占全部的25.33%。在不同时间段有不同的妊娠结局,＜12周以流产为主,12-28周以早产和流产较多,>28周-足月则以足月产为主。感染发生率为4%。结论:妊娠合并卵巢肿瘤通常无临床症状,超声和实验室检查有助于鉴别诊断,早期干预对妊娠结局至关重要。     

妊娠合并卵巢肿瘤62例临床病理分析

妊娠合并卵巢肿瘤６２例临床病理分析王小青南京市妇产医院妇产科（南京市２１０００４）妊娠合并卵巢肿瘤，可引起各种并发症。除阻碍胎儿分娩外，尚可发生肿瘤蒂扭转、肿瘤破裂、感染、腹膜炎等，危及母、儿生命。本文就１９８８年至１９９３年我院６２例妊娠合并卵巢肿...     

Solitary Brain Metastases from Uterus Carcinoma: Report of Three Cases

Solitary brain metastases from uterine carcinoma are uncommon. Intracranial metastases from uterus usually occur in widely disseminated disease. We report three cases of solitary brain metastasis from uterine cancer. In one of these patients metastasis was detected prior to diagnosis of primitive cancer. In a review of the literature only seven cases of solitary brain metastasis preceding the diagnosis of uterine cancer have been documented.     

卵巢癌合并皮肌炎1例报告

患者４９岁 ,因皮疹伴瘙痒１个月于２０００年１２月２５日入院。患者１个月前因面部、双手背皮肤紫斑伴瘙痒 ,压之褪色 ,以眼睑为明显 ,逐渐扩散到整个面部颈部 ,四肢肌力Ⅱ级 ,皮生化检查后确诊为皮肌炎。于２００１年初始激素治疗 ,强的松片５０ｍｇ／天 ,症状好转 ,皮生化正常 ,激素逐渐减量。３个月后 ,因气急 ,腹胀行Ｂ超提示胸腹水 ,盆腔包块 ,ＣＡ１２５＞３０００ＩＵ／ｍｌ诊为卵巢癌合并皮肌炎 ,经充分的术前准备 ,皮肌炎症状缓解、稳定后 ,于２００１年６月２１日在全麻下行子宫次全切除 +双附件切除 +大网腹切除 +减瘤术 ,术后…     

残角子宫妊娠6例临床分析

残角子宫妊娠在临床上较罕见，易误诊，早期诊断极为重要。我院于近27年间收治了6例残角子宫妊娠的患者，均予以手术治疗。4例均在妊娠3．5-5个月发生残角子宫破裂，内出血在2000ml以上，1例因人流术中未见绒毛，术后血HCG持续阳性．子宫右侧发现包块而及时手术。1例为残角子宫同侧输卵管壶腹部妊娠破裂行右输卵管及残角子宫切除术。     

泰素治疗八例晚期复发的卵巢癌

目的：验证泰素对晚期、复发的卵巢上皮癌的疗效。方法：回顾分析1994年7月至1995年3月国内最早试用美国百时美施贵宝公司提供的商用泰素治疗8例卵巢癌的结果。结果：8例可评价病人中，3例达到部分反应（PR），总反应率37.5％（3／8），主要副作用是脱发、腹痛、腹泻和感觉异常。结论：证明泰素对晚期、复发的卵巢上皮癌治疗的有效性，特别是有效者明显延长了生存期。     

Docetaxel Therapy for Advanced Hepatocellular Carcinoma Developed in Healthy Liver: Report of Three Cases

Abstract

Systemic chemotherapy is generally ineffective in patients with advanced hepatocellular carcinoma (HCC). This could be partly explained by the frequent underlying cirrhosis, which induces serious toxicity requiring dose attenuation or drug discontinuation. We present observations of three patients with HCC developed in healthy liver and treated with docetaxel (100 mg/m² every 3 weeks in one patient; 30 mg/m² weekly, three times every 4 weeks in two patients). An objective partial response with long-term survival was obtained in all cases without severe toxicity. These results suggest that chemotherapy, and especially docetaxel, could be safe and effective in patients with HCC developed in healthy liver, and should be assessed in specific trials.     

Differential Diagnosis of Pancreatobiliary Carcinoma from Autoimmune Pancreatitis-Related Diseases: A Report of Three Cases

Background

“Japanese clinical guidelines for autoimmune pancreatitis” advised to carefully differentiate between two conditions: autoimmune pancreatitis (AIP) and associated sclerosing cholangitis (SC), and pancreatobiliary malignancy.

Methodology

We report a series of three cases for which differential diagnosis of pancreatobiliary carcinoma from AIP and associated SC was crucial.

Result

Three patients presented with biliary stenosis secondary to pancreatic swelling or mass lesion, followed by further examinations: Case 1 was first diagnosed as having tumor-forming pancreatitis associated with AIP but eventually proven to be pancreatic head carcinoma; case 2 was operated for suspected bile duct cancer combined with AIP and associated cholangitis, and early cancer was found in the resected specimen; case 3 was operated on for presumed cholangiocarcinoma combined with AIP-associated SC, but no malignancy was found.

Conclusions

Current series of cases would raise an alert on diagnosis of AIP and associated SC, and pancreatobiliary malignancy should be carefully excluded by any means. Surgical intervention would be required in selected cases of this clinical entity.     

肾脏偶发癌16例报告

报告１９８８年至１９９７年收治的肾脏偶发癌１６例,占同期肾癌的２１．３％。经Ｂ超扫描发现１４例,ＣＴ扫描发现１１例,术中病理切片证实１例。行根治性肾切除１５例,肾部分切除１例。病理诊断为透明细胞癌１３例,颗粒细胞癌２例,混合型癌１例。病理分期：ＰＴ１４例,ＰＴ２１２例。随访１３例,平均随访３２．５个月。１２例无癌生存,５例术后存活超过５ａ。     

甲状腺髓样癌6例临床报道

目的探讨甲状腺髓样癌(MTC)的临床及病理形态特征。方法结合临床资料及文献对6例甲状腺髓样癌的光镜、组织化学、免疫组化特点进行分析和研究。结果患者年龄27～65岁,均为散发型甲状腺髓样癌,病程1个月～1年,2例以颈部淋巴结肿大为首发症状,其余4例均为单侧甲状腺肿大。2例伴有局部压痛,肿瘤最大直径为6.5cm,最小直径为2.0cm。癌组织中降钙素CT、GEA、syn、cgA均呈阳性,5例NSE阳性,淀粉样物质染色均呈阳性。结论MTC具有多分化肿瘤的特点,可以表达多种神经内分泌物质。     

中枢神经细胞瘤3例报告

报告3例中枢神经细胞瘤,结合文献探讨中枢神经细胞瘤的病理特点和治疗.     

Endobronchial Lipoma: A Report of Three Cases

Although lipomas are common benign neoplasms of soft tissue,endobronchial lipoma is rare. We have treated three patientswith endobronchial lipoma over the five years. In two of themlesions were located in segmental or subsegmental bronchi andproduced no symptoms. There are very few such cases reportedin the English medical literature. In the first case, pneumonectomywas performed because of destruction of the lung due to recurrentpneumonia. The second case had no symptoms and the tumor waslocated at the bifurcation of right B⁴a and B⁴b. A right middlelobectomy was performed, because the distal end of the tumorcould not be visualized by fiberoptic brorichoscopy. In thethird case, which was a case of lung cancer, an endobronchiallipoma was found during fiberoptic bronchoscopy, and was completelyremoved endoscopically. Due to their benign nature, endobronchiallipomas should be initially treated with endoscopic surgeryor endoscopic laser vaporization. Nevertheless, if the tumoris large and dumbbell-shaped on tomography or CT, endoscopicprocedures are not appropriate. Furthermore, if destructivepulmonary change due to the tumor is severe, the remaining peripherallung will not recover after endoscopic procedures, even if theyare removed successfully. When the biopsy specimen is too smallto allow evaluation of the whole tumor, surgical resection shouldalso be considered for definitive diagnosis.