青春期少女卵巢上皮性肿瘤的临床特点及治疗

目的探讨青春期少女卵巢上皮性肿瘤的临床特点及治疗方法。方法回顾性分析北京协和医院1983年1月-2002年10月间收治的全部13～19岁卵巢上皮性肿瘤患者29例。其中,良性肿瘤20例、交界性肿瘤4例、恶性肿瘤5例。结果患者平均年龄16．5岁,其中13-14岁3例(10％)、15．16岁9例(31％)、17-19岁17例(59％)。临床表现主要为腹痛、腹胀、下腹部巨大肿物。病理类型：黏液性肿瘤22例,浆液性肿瘤6例,子宫内膜样肿瘤1例。手术病理分期：交界性或恶性肿瘤患者9例中,Ⅰ期8例,Ⅲc期1例。治疗：良性肿瘤20例中,开腹行一侧附件切除术9例,腹腔镜下行卵巢囊肿剔除术11例;9例交界性或恶性肿瘤患者全部施行了肿瘤细胞减灭术和全面的分期手术,其中8例I期患者保留了生育功能,1例Ⅲc期患者未保留生育功能;5例恶性肿瘤患者中,4例接受了4-6个疗程以顺铂为主的化疗。随访期间良、恶性肿瘤无一例复发。结论青春期少女卵巢上皮性肿瘤的发生率随年龄的增长而增加;黏液性肿瘤是最常见的病理类型。对于多数良性肿瘤患者可以考虑腹腔镜下行肿瘤剔除术;对于交界性或恶性肿瘤患者应兼顾治愈肿瘤和保留生育功能,治疗方案应个体化。

Epithelial ovarian tumors in adolescence: a study of clinical features and treatment

OBJECTIVE: To study the clinical feature, diagnosis and treatment of epithelial ovarian tumors in adolescent patients. METHODS: A retrospective analysis was performed on 29 patients of epithelial ovarian tumors between the age of 13 and 19 during the period of 1983 - 2002 in Peking Union Medical College Hospital. Twenty of the cases were with benign tumors, four with borderline, and five with malignant tumors. RESULTS: The average age was 16.5 years old. The majority of patients presented with abdominal pain, abdominal distention and a large pelvic mass. The histological types included mucinous tumor in twenty-two cases, serous tumor in six, and endometroid tumor in one case. Among the nine cases with borderline or malignant tumors, eight were at stage I and one at stage IIIc. Of benign tumor group, an abdominal unilateral salpingo-oophorectomy was performed on nine cases. A laparoscopic cystectomy was undertaken in 11 patients. The nine cases with borderline or malignant tumors underwent cytoreductive surgery and comprehensive staging surgery; fertility was preserved for eight of them. A cisplatin combined chemotherapy was given to four patients with malignant tumors. All of the patients were without evidence of disease recurrence during the follow-up. CONCLUSIONS: The incidence of epithelial ovarian tumors during adolescence increases with age. Mucinous tumor is the most common histological type in adolescent patients. A laparoscopic cystectomy could be considered for most benign patients. The therapeutic strategy should be individualized, and surgical approach should consider both cure and preservation of fertility in malignant cases.