卵巢甲状腺肿20例临床分析

目的:探讨卵巢甲状腺肿诊断及治疗。方法:回顾性分析本院近年收治的卵巢甲状腺肿20例的临床资料,综合文献复习。结果:本病发病年龄22～75岁,临床表现为腹痛、腹胀、腹水及附件包块,CA_(125)可增高。20例中18例为良性,2例为恶性。除2例外院术后诊断为恶性卵巢甲状腺肿外,其余18例术前均未明确诊断。全子宫与双附件切除者3例;全子宫与单侧附件切除者3例;开腹囊肿剔除6例;腹腔镜囊肿剔除6例;1例于外院行开腹卵巢囊肿剔除术,病理为卵巢甲状腺肿合并微小乳头状癌,术后1个月于本院行再分期术,1例于外院行全子宫与右附件和左卵管切除术,术后1个月入本院,PVB(顺铂+长春新碱+博莱霉素)化疗1个疗程出院。8例送冰冻,1例报告为畸胎瘤,余报告均为卵巢甲状腺肿。结论:卵巢甲状腺肿是一种高度特异性卵巢畸胎瘤,具有发病率低、临床表现不特异、术前术中诊断困难等特点。良性卵巢甲状腺肿宜行卵巢囊肿剔除术(腹腔镜或开腹)。多数恶性卵巢甲状腺肿的病变局 限于卵巢,宜选择分期术,术后PVB或PEB(顺铂+足叶 乙甙+博莱霉素)化疗。

The Clinic Study on 20 Cases of Struma Ovary

Objective: To study the diagnosis and treatment for struma ovary. Methods: 20 cases of struma ovary were analyzed by retrospective analysis method. Results: The age of patient often ranged from 22 - year - old to 75 - year - old. Clinical symptoms showed abdominalgia, abdominal distention, ascites, abdominal mass and an elevated Cal25 level. 18 cases were benign and 2 cases were malignant. 18 cases all were uncertainly diagnosed before surgery except for the two cases that were diagnosed as malignant struma ovary at other hospital after operations. 3 cases received hysterectomy and bilateral salpin-go - oophorectomy. 3 cases received hysterectomy and unilateral salpingo - oophorectomy. 6 cases received laparocystectomy. 6 cases received laparoscope cystectomy. Receiving salpingo - oophorectomy at other hospital, 1 case with struma ovary and papillocarcinoma received operation by stages after one month at our hospital. Receiving hysterectomy and right salpingo - oophorectomy and left laparosalpingotomy at other hospital, 1 case received PVB ( Cis - platin Vincristine Bleomycin ) chemotherapy one time at our hospital. 8 cases were diagnosed by frozen section, and lease was teratoma, and other cases were struma ovary. Conclusion: Struma ovary is highly specialized teratoma with low incidence, nonspecific clinical manifestation and poor diagnosis. Benign struma ovary should be treated by laparocystectomy or laparoscope cystectomy. Most of malignant struma ovary is localized at ovary, and it is should be staging surgery and PVB or PEB( Cisplatin Etoposide Bleomycin) chemotherapy.