盆腔腹膜外深部侵袭性血管黏液瘤1例

病例 女,39岁.2008年9月因脾大入院,B超发现盆腔囊实性占位,遂行CT扫描,考虑卵巢囊腺瘤,患者在我院行脾脏切除手术.2009年2月患者要求切除盆腔肿块,术前检查:查体:月经周期3～4/30 d,无痛经、下腹痛、尿频、便秘等症状,既往无外伤、腹部感染.妇检未见异常.实验室检查:白细胞、红细胞及中性粒细胞正常范围,β2微球蛋白2.72 mg/L,CEA 1.61 μg/L,CA125 14.79 u/mL,AFP 3.06 Iu/mL,CA19-920.16 Iu/mL.2012年7月患者感觉下腹部坠胀感,尿急、尿频,临床诊断泌尿系感染,行超声检查:盆腔内见一巨大低回声团16.6 cm×10.9 cm×9.5 cm,边界清晰,其内见条状强回声.行CT检查后提示肿瘤复发,再次行手术切除.     

盆腔侵袭性血管黏液瘤CT/MRI影像特征1例报告

正侵袭性血管黏液瘤(aggressive angiomyxoma,AAM)是一种罕见的软组织肿瘤,好发于育龄期妇女。AAM患者常无明显临床症状,体格检查及实验室检查无明显异常,术前难以确诊,常被误诊为前庭大腺囊肿或其他间叶源性肿瘤(如富含黏液成分的脂肪肉瘤、平滑肌瘤及血管瘤等)。术前影像学检查(CT及MRI)可以辅助确定肿瘤范围,具有一定特异性。因此,本文分析了1例AAM患者的     

侵袭性血管粘液瘤的影像诊断研究

目的:研究侵袭性血管粘液瘤(AAM)的影像特征表现。材料与方法:收集2012—2016年我院经手术及病理证实为AAM且有术前影像检查的10例患者(女7例,男3例),对其临床、影像及病理资料进行回顾性分析。结果:10例患者中,6例病变发生于会阴及盆腔,其中3例跨盆膈生长,其余4例分别位于外阴、右侧大腿、腹膜后及回盲部。9例病变的最大径线为上下径。在7例增强CT检查中,3例轻度强化,4例明显强化,其中3例可见分层强化,1例可见钙化。在6例MRI检查中(5例为增强MRI),5例T_2WI呈高信号,4例明显强化,3例可见分层强化。结论:AAM具有一定的临床及影像特点。生育年龄女性患者,位于会阴区或跨盆膈生长,T_2WI高信号为主且具有分层影像特点的肿瘤对该病的诊断有一定的价值。     

侵袭性血管黏液瘤一例

患者女,36岁,14年前发现左侧臀部肿物,直径约2cm,突出于皮面,无红肿热痛表现,于13年前在外院行体表肿物切除术后,考虑为纤维血管瘤。切除后肿物复发并逐渐增大,3年前CT检查提示阴道占位。发病后大便次数增多,无发热腹痛。     

外阴侵袭性血管黏液瘤MRI表现1例

患者女,27岁,主因"发现外阴肿物5年余"就诊;患者5年前无明显诱因出现外阴淤血,并可触及直径约1 cm的活动性肿物,未予诊治,其后肿物逐渐增大.查体:外阴部可见约手掌大小的肿物,活动度尚可,无触痛.盆腔MRI:外阴左侧皮下见10.4 cm×8.7cm×5.2 cm不规则长T1长T2信号,向上延伸至左下腹皮下约膀胱水平,边界清晰,未侵及周围组织;增强扫描病灶呈不均匀明显强化(图1).MRI诊断:外阴占位性病变,血管肉瘤不除外.行外阴肿物切除术,术中见肿物位于皮下,包膜完整,切面淡黄色、部分呈胶冻样.术后病理:侵袭性血管黏液瘤(aggressive angiomyxoma,AAM,图2).     

神经鞘黏液瘤1例

病例 男，24岁。5个月前无明显诱因出现左臀部包块，呈渐进性增大,伴有明显傻间痛；劳累后加重，未于重视；近20天来,左臀部酸痛加重，活动行走时疼痛明屁，休息后减轻,无恶寒、发热，无午后低热及夜间盗汗等。曾就诊当地医院，予输液抗炎止痛药处理后疼痛症状缓解。     

Aggressive angiomyxoma of the pelvis and perineum: a case report and review of the literature

Aggressive angiomyxoma is a rare tumor that affects the pelvis and perineum in women of reproductive age. Here we present the typical CT and MRI appearances of a 36-year old young woman with an aggressive angiomyxoma of the pelvis and perineum that was proved by postoperative pathology. We also review the CT and MRI features of this disease in the current literature.     

Aggressive angiomyxoma of the vulva: case report and literature review

Aggressive angiomyxoma is a rare softtissue tumour, typically occurring in the female pelvis and carrying a high risk of local infiltration and relapse. Surgery remains the first line of treatment, however some adjuvant treatments, such as gonadotrophin-releasing hormone (GnRH) agonists, have been used for primary treatment and for treatment against tumour recurrence. We describe a case of vulvar aggressive angiomyxoma in a 31-year old woman who underwent surgical excision of the tumour. Diagnosis was made on the basis of histopathological examination and positive immunohistochemical staining with oestrogen and progesterone receptors. Postsurgery, a GnRH agonist (3.75 mg triptorelin) was injected intramuscularly every month for 3 months to prevent tumour recurrence and, to date, no relapse has been observed. Whether treatment is with surgery, hormone therapy or both, it is clear that aggressive angiomyxoma requires close, long-term follow-up to monitor for disease recurrence and that the individualization of each case is essential for adequate management.     

盆腔多发脾种植误诊1例

病例 女,31岁.主因经期腹痛10年,加重3个月入院.患者于13年前因外伤脾破裂行脾脏切除术.查体:体温36.5℃,脉搏75/min,呼吸16/min,血压120/70mmHg.心肺查体未见明显异常.左季肋郎可见手术缀痕.妇科查体:子宫大小正常,活动好,子宫后方可触及直径约4cm×4cm×3cm质韧包块.     

腰大肌内侵袭性纤维瘤病1例

病例男,57岁。发现左肾下极区肿物3天而入院,病程中无腰痛及肉眼血尿。查体:腹部平坦,未触及包块,双肾区叩击痛阴性。各项化验均未见异常。CT平扫及增强:腹膜后