促排卵后快速进展的双侧卵巢库肯勃瘤一例报告并文献复习

报告1例37岁女性在促排卵治疗后5 d出现腹胀、腹水、双侧卵巢对称性多囊性增长,按照卵巢过度刺激综合征治疗近1个月无好转,双侧卵巢肿瘤由囊性变为囊实性。CT引导下卵巢肿瘤内部实性组织穿刺病理检查为腺癌,剖腹探查及病理证实为缩窄型结肠低分化腺癌及双侧卵巢库肯勃瘤（Krukenberg瘤）。患者术后接受了6个疗程奥沙利铂+贝伐珠单抗+卡培他滨化疗,现病情稳定。此例为在促排卵状态下,盆腔丰富的血供及淋巴循环促进了结肠癌来源的双侧卵巢Krukenberg瘤快速生长的病例,临床上较为罕见,结合文献复习辅助生殖技术对原发性卵巢恶性肿瘤的潜在致病风险及对转移性卵巢恶性肿瘤生长的影响。

The Rapid Development of Bilateral Ovarian Krukenberg Tumors after Ovarian Stimulation: A Case Report and Literature Review

A 37-year-old woman developed abdominal distension, ascites and bilateral ovarian symmetrical ovarian cysts 5 days after ovulation induction treatment and progressed after anti-ovarian hyperstimulation syndrome therapy for about 1 month. The bilateral ovarian tumors have changed from cystic to cystic-solid. CT-guided puncture and pathological examination of solid tissue inside the ovarian tumor showed adenocarcinoma. The exploratory laparotomy and pathology revealed bilateral ovarian Kukenbergs derived from poorly differentiated constricted colon adenocarcinoma. The patient receives 6 cycles of systemic chemotherapy of oxaliplatin (FOLFOX), bevacizumab plus capecitabine regimen and is alive now with no recurrence. The rapid progress of bilateral ovarian Kukenberg tumors after ovulation induction is rare. Here, we report this case and review the potential pathogenic risks of assisted reproductive technology on primary ovarian malignancies and the impact on the growth of metastatic ovarian malignancies.