78例子宫富于细胞型平滑肌瘤临床病理分析

目的:分析子宫富于细胞型平滑肌瘤(CUL)的临床病理特点,探讨其生物学行为及临床结局.方法:回顾性分析了2000年1月至2007年1月在我院收治的78例CUL患者的病历资料,并对全部患者进行了随访.结果:CUL病理特点为瘤细胞丰富,细胞大小形态尚一致,核分裂相0-4个/10HPF;临床表现以月经改变为主;超声检查以低回声多见.行肌瘤剔除术患者复发率为22.8%.结论:CUL的临床表现与普通子宫平滑肌瘤相似,治疗应酌情选择全子宫切除或肌瘤剔除术.     

子宫静脉内平滑肌瘤临床病理分析

目的 探讨子宫静脉内平滑肌瘤的临床生物学特征及治疗手段对预后的影响。方法 对北京协和医院和江西省妇幼保健院1992年6月至2003年6月间收治并经手术及病理检查证实的子宫静脉内平滑肌瘤7例患者的临床和病理资料进行回顾性分析,全部病例均随访。结果 临床表现：7例患者均以盆腔包块为主诉,其中3例盆腔包块超过妊娠12周子宫大小,最大者妊娠16周大小;2例表现为经期延长、经量增多,1例表现为绝经后出血。超声检查：4例提示子宫肌瘤,1例提示子宫肉瘤,2例提示卵巢肿瘤,术前确诊率为0。术中冰冻检查：2例中1例确诊。手术治疗：4例行全子宫及双侧附件切除术,2例行全子宫及一侧附件切除术,1例仅行肌瘤剔除术;1例行子宫及一侧附件切除术患者术后2年复发,瘤栓沿下腔静脉转移至右心房及右心室再次手术治疗。结论 子宫静脉内平滑肌瘤具有特殊的不良生物学行为,提高术中确诊率与正确选择手术方式及术后密切随诊可以改善其预后。     

特殊类型的子宫平滑肌瘤32例临床病理分析

特殊类型的子宫平滑肌瘤，是临床上比较少见的一类子宫平滑肌肿瘤，这类肿瘤镜下细胞丰富活跃，核分裂相多，有不同程度的异型性，有时见奇异瘤细胞，易与子宫平滑肌肉瘤混淆，临床经过却多表现为良性，因此应重视这类肿瘤，掌握其临床病理特征及与子宫平滑肌肉瘤的鉴别，以免误诊。同时，因也有极少数复发及转为恶性的病例，对此类肌瘤应加强随访。     

子宫平滑肌瘤红色变性7例分析

<正> 子宫肌瘤是女性生殖器官中最常见的良性肿瘤,但发生红色变性者较少见,我院1992年至1995年诊治子宫平滑肌瘤红色变性7例,现报告如下。 1 临床资料 1992年至1995年我院诊治子宫平滑肌瘤     

良性转移性平滑肌瘤转移病2例

一、病例摘要病例1:女性患者,24岁,未婚,有性生活史。3年前(2001年12月)因“子宫平滑肌瘤”行“子宫肌瘤剔除术”。术后1个月复查发现盆腔包块,随访中逐渐增大。半年后行“左附件肿瘤切除术”。术后病理示:左输卵管系膜平滑肌瘤,伴细胞生长活跃。两次手术术前胸片均未见异常。2     

子宫交界性平滑肌瘤的病理诊断及临床特征

在子宫平滑肌瘤与肉瘤之间存在一组交界性肿瘤，包括子宫富于细胞型，奇异型，核分裂活跃型，不典型及恶性潜能未定型平滑肌瘤。本研究对原诊断为子宫富于细胞型平滑肌效４２例，进行重新诊断，同时收集其临床资料并随访。结果：４２例中，富于细胞型平滑肌瘤５例，奇异型平滑肌瘤１例，不典型平滑肌瘤７例，恶性潜能未定型平滑肌瘤２例，肉瘤１例及普通平滑肌瘤２６例。在细胞丰富的基础上，细胞异型与核分裂的关系密切；不同月经周     

子宫静脉内平滑肌瘤病64例临床病理分析

目的:研究子宫静脉内平滑肌瘤病的临床病理特征,探讨该疾病的诊断和治疗策略。方法:回顾分析2007年7月至2013年6月复旦大学附属妇产科医院收治的64例静脉内平滑肌瘤病患者的临床病理资料。结果:子宫静脉内平滑肌瘤病的临床表现缺乏特异性,与普通子宫平滑肌瘤类似,主要为月经量增多、腹痛腹胀、盆腔肿块及继发贫血。仅有3例在术前彩色多普勒超声检查中被疑诊为子宫静脉内平滑肌瘤病。术中冰冻病理多能提示静脉内平滑肌瘤病,肌瘤主要位于子宫体(73.4%)、阔韧带(18.8%)及子宫峡部(7.8%)。手术方式包括子宫肌瘤剥出术(4.7%)、全子宫切除术(39.1%)及全子宫+双附件切除术(56.2%)。术后获访的50例患者的随访中位时间为28个月,仅有1例在子宫肌瘤剥出术后复发,行全子宫切除术后随访至今未复发。结论:子宫静脉内平滑肌瘤病术前诊断困难,手术切除是主要治疗方式。术中仔细探查,选择适当的手术方式可获得满意的治疗效果,术后需密切随访。     

宫颈肌瘤全子宫切除术40例临床分析

我院自2000年1月至2003年12月共收治直径≥9·5cm的宫颈肌瘤40例,均经病理检查证实。占同期子宫肌瘤手术的2·8%(40/1424)。患者年龄31~54岁,平均(43·93±4·83)岁。全部为已婚已育妇女。半数以上患者伴有尿频、排尿困难,偶有月经量过多。宫颈肌瘤分型:根据手术探查将宫颈肌瘤     

子宫富细胞平滑肌瘤47例临床病理分析

研究了了宫富细胞平滑肌瘤的临床及病理特征。方法分析了４７例子宫富细胞平滑肌瘤的临床及病理特征,并对其中３５例进行追踪随访。结果本病症状主要包括月经改变、贫血、疼痛、不孕主前诊断均为子宫肌瘤。结论子宫富细胞平滑肌瘤是一种良性肿瘤,术后不必补充化疗或放疗,预后良好。     

富于细胞型子宫平滑肌瘤临床危险因素分析

目的:分析富于细胞型子宫平滑肌瘤(CUL)的临床危险因素。方法:回顾分析2012年7月至2015年5月于我院行子宫肌瘤手术的患者232例,其中40例CUL患者,记录全部患者基本信息、肌瘤数目、大小、位置,B超血流信号,并随访术后子宫肌瘤复发情况。结果:年龄因素(年龄≥40岁)、肌瘤大小(肌瘤大小为5~8cm)、血流信号丰富(呈火球样、呈星、条或网状分布)是CUL发生的相关危险因素(P0.05)。术后随访2年,CUL术后复发率高于普通平滑肌瘤(P0.05)。结论:年龄、肌瘤大小、血流信号丰富是CUL发生的危险因素。     

子宫富于细胞型平滑肌瘤55例临床分析

目的研究子宫富于细胞型平滑肌瘤的临床特征和病理特点。方法对1998年2月~2005年4月经病理诊断为子宫富于细胞型平滑肌瘤的患者55例(研究组)及随机抽取普通平滑肌瘤120例(对照组),就其症状、体征、手术所见、大体标本及预后进行对照分析。结果子宫富于细胞平滑肌瘤的发病年龄、肿瘤的增长速度、大小、质地与普通平滑肌瘤之间存在明显差异:子宫富于细胞平滑肌瘤发病年龄相对较轻,增长速度较快,较易向阔韧带内生长,质地偏软。随访有3例复发,5例妊娠或生育。结论子宫富于细胞平滑肌瘤发病年龄相对较轻,增长速度较快,瘤体较大,向阔韧带内生长,术中易出血,术后应加强随访。     

妊娠合并子宫肌瘤130例临床分析

目的探讨妊娠合并子宫肌瘤的临床处理。方法回顾性分析我院5年来130例妊娠合并子宫肌瘤患者处理方法以及产科结局。结果发现妊娠期间肌瘤增大者共11例，72．73％发生于孕早中期，变性类型多样，红色变性占57．69％；130例妊娠合并子宫肌瘤者中，发生早产14例，占10．77％(14／130)，发生产后出血6例，占4．62％(6／130)，其发生率高低与肌瘤的数量、部位及大小之间无明显关系；剖宫产者122例，占93．85％。结论妊娠合并子宫肌瘤易发生各种产科并发症，剖宫产率高，剖宫产术中行肌瘤剔除术应慎重。     

Pregnancy after embolization of uterine myoma: report of 12 cases

Objective: To treat uterine myomas with embolization, to look for pregnancy-induced myoma recurrences, and to assess pregnancy course and outcome after embolization.

Design: Observational clinical study.

Setting: University of Paris VII hospital.

Patient(s): Nine women had embolization for symptomatic myoma, with 12 pregnancies observed.

Intervention(s): Embolizations were highly selective and performed bilaterally through the uterine arteries with polyvinyl alcohol.

Main Outcome Measure(s): Pregnant women were evaluated by physical and sonographic examinations.

Result(s): Before embolization, the mean uterine volume was 450 cm³, and in six patients polymyomas were present. The median age at embolization was 40 years; the median delay before pregnancy was 9 months; and the median age at first pregnancy outcome was 41 years. Five early miscarriages occurred. The seven other pregnancies were uneventful, although three premature births and one case of late toxemia occurred unrelated to previous embolization. Three women delivered vaginally and four by cesarean section. Neither myoma recurrence nor abnormality in uterine function was observed.

Conclusion(s): The results of this first series of 12 pregnancies after myoma embolization are promising. If these preliminary results are confirmed, embolization could be a major breakthrough in the management of myoma and could replace conventional medical and surgical treatments.     

Non-puerperal incomplete lateral uterine inversion with submucous leiomyoma: a case report

A perimenopausal, multiparous woman presented with prolapse. Clinically, there was a doubt between prolapsed submucous leiomyoma and uterine inversion. Laparoscopy showed an unusual pattern of uterine inversion restricted to the left cornual region with a submucous leiomyoma. A vaginal hysterectomy with due considerations for alterations of anatomical relationships minimized operative morbidity.     

Iatrogenic parasitic myoma: A case report and review of the literature

ObjectiveTo investigate the possible causes of iatrogenic parasitic myoma and methods to prevent its occurrence.Case reportA 27-year-old nulliparous unmarried patient underwent laparoscopic myomectomy with morcellation for a submucosal myoma at the National Taiwan University Hospital (Taipei, Taiwan). Seven years later, an asymptomatic pelvic tumor was noted during a regular annual follow up. Two pelvic tumors were detected and excised by laparoscopic surgery. The masses were confirmed by histopathology to be cellular leiomyomas.ConclusionIn the past 7 years, the incidence of iatrogenic parasitic myomas has increased because of the increased use of minimally invasive surgery using a morcellator. Forty-one cases of iatrogenic parasitic myoma were reviewed from 23 published studies. Parasitic myoma frequently occurs in the dependent part of the abdominal cavity, which suggests seeding of myometrial tissues during morcellation. In situ morcellation and vigorous irrigation with concomitant changes in position may decrease the incidence of retained myoma tissue in the abdomen during surgery.     

决策板在子宫肌瘤住院患者中应用的临床意义

目的:探讨决策板在子宫肌瘤住院患者中应用的临床意义。方法:作者设计了一种工具,称为“决策板”,通过它向子宫肌瘤住院患者传递相关的医学信息,然后由医生和患者共同商议后再选择术式。采用前瞻性研究方法随机将140例绝经前的子宫肌瘤住院患者分为两组,研究组进行决策板管理,对照组进行常规术前谈话,比较出院时两组患者的满意度及所采取的4种术式的比率。结果:研究组90％的患者认为决策板易理解,96％的患者认为此项措施有助于手术方案的选择,患者满意度调查结果为:非常不满意、不满意、一般、满意、非常满意分别占1.43％（1/70）、2.86％（2/70）、28.57％（20/70）、47.14％（33/70）、20.00％（14/70）;对照组患者满意度调查结果为:非常不满意、不满意、一般、满意、非常满意分别占1.43％（1/70）、8.57％（6/70）、47.14％（33/70）、35.71％（25/70）、7.14％（5/70）。两组差异有显著性（P<0.05）。研究组中选择全子宫切除术、次全子宫切除术、子宫肌瘤挖除术、腹腔镜筋膜内子宫切除术的比率分别为:64.3％、8.6％、21.4％、5.7％;对照组中选择全子宫切除术、次全子宫切除术、子宫肌瘤挖除术、腹腔镜筋膜内子宫切除术分别为:81.4％、4.3％、10.0％、4.3％。两组差异无显著性（P>0.05）。结论:将决?     

Unilateral primary ovarian leiomyoma in adolescent: a case report

Background Primary ovarian leiomyoma is a rare, usually small and incidentally detected neoplasm, clinically indistinguishable from subserous leiomyomas and ovarian fibromas, until histopathological confirmation. Case report We report a rare case of unilateral, ovarian leiomyoma that was not associated with uterine tumor in a 17-year-old woman. Trans abdominal ultrasonography and magnetic resonance imaging (MRI) revealed a pelvic mass (15 cm × 12 cm). Conclusion At laparotomy, unilateral salpingo-oophorectomy was performed and histologic examination revealed a leiomyoma arising primarily in the ovary.     

Consumptive coagulopathy that developed in a pregnant woman with degenerated uterine leiomyoma: case report

A case of consumptive coagulopathy in a 30-year-old pregnant woman with degenerated uterine leiomyoma is described. She developed lower abdominal pain at 21 weeks of gestation. Laboratory profiles revealed coagulation abnormalities. Magnetic resonance imaging diagnosed degenerated uterine leiomyoma. At 34 weeks, she underwent cesarean section and myomectomy. Pathological examination showed the presence of organized thrombi in the vessels of leiomyoma. The consumption of platelets and coagulation factors in degenerated uterine leiomyoma may result in consumptive coagulopathy.     

Successful treatment of submucosal myoma with acute severe uterine hemorrhage by emergency uterine arterial embolization followed by early hysteroscopic myomectomy: a report of two cases

Two submucosal myoma cases with acute severe uterine hemorrhage were initially treated by emergency uterine arterial embolization for hemostasis. Then, after improvement of the general condition, early hysteroscopic myomectomy was performed. In one patient, complete resection was achieved. In another patient, the initial resection was incomplete because of the large tumor size. However, the remaining myoma tissue was spontaneously expelled later with no complications. Red blood cell transfusion was not required in either patient.