3例妊娠合并卵巢恶性肿瘤分析及文献回顾

目的 探讨妊娠合并卵巢恶性肿瘤的诊治方法.方法 回顾分析妊娠合并卵巢恶性肿瘤3 例,结合文献探讨其诊断、治疗及预后.结果 近3 年我院分娩孕妇共3 869 例,2 例孕早期超声检查发现卵巢囊肿,1 例晚孕超声发现盆腔巨大肿瘤.1 例剖宫产术中行肿瘤剥除术,病理为卵巢高分化上皮性癌,行肿瘤细胞减灭术、化疗,现无瘤生存;另2 例术前疑为恶性肿瘤,其中1 例孕27 周行剖腹探查术,病理为未成熟畸胎瘤III 级,孕40 周自然分娩,产后行肿瘤细胞减灭术、化疗、纵隔转移瘤切除术,病理有逆转倾向,现无瘤生存;另1 例孕32+2 周行剖宫产、剖腹探查术,术后证实为胃癌卵巢转移,术后6 月全身广泛转移死亡.3 例新生儿均健康.结论 妊娠合并卵巢恶性肿瘤应依据肿瘤组织类型、分期、孕周及孕妇意愿采用不同处理方案,实现个体化治疗.

Diagnosis and treatment of malignant ovarian tumor in pregnant women:A report of 3 cases and review of the literature

Objective To study the diagnostic and treatment methods of malignant ovarian tumor in pregnant women.Methods Diagnosis,treatment and prognosis of ovarian malignant tumor in 3 pregnant women were retrospectively analyzed with the related literature reviewed.Results Among the 3 869 pregnant women admitted to our hospital in the past two years for childbirth,early ovarian cysts were found in 2 and a giant pelvic tumor in 1 by ultrasonography.The tumor was removed in caesarean section.Pathology examination showed that the tumor was a highly differentiated ovarian epithelial cancer,which was removed by cytoreductive surgery and received chemotherapy.The patient had a tumor-free life when we wrote this paper.Two were suspected with malignant ovarian tumor before operation,one of them underwent exploratory laparotomy,chemotherapy,removal of mediastina metastatic tumor 27 weeks after gestation with a reversion tendency.The patient had a tumor-free life when we wrote this paper.The other received caesarean section and exploratory laparotomy at the 32+2 gestational weeks.She was diagnosed as metastatic ovarian tumor from stomach and died of general metastasis after 6 months.The 3 newborns were healthy when we wrote this paper.Conclusion Malignant ovary tumor in pregnant women should be treated according to its histology type and phase,and the gestational weeks and will of pregnant women.