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目的:探讨子宫静脉内平滑肌瘤病(IVL)的临床特点。方法:回顾性分析2004-04-2008-05诊治的9例子宫IVL的临床和病理资料。结果:9例IVL患者中,7例患者主诉盆腔包块,1例经期延长、经量增多,1例腹痛;7例盆腔包块超过妊娠12周子宫大小,最大者达妊娠20周大小,子宫全切术后和子宫肌瘤剔出术后各1例;超声检查提示子宫肌瘤8例,盆腔实性肿瘤1例,5例子宫肌瘤血流丰富,其中2例血流呈树枝状,术前无一确诊为IVL。全部患者均接受手术治疗,4例行全子宫+双侧附件切除术,4例行全子宫切除术,1例行盆腔肿瘤切除术。1例患者子宫+双附件切除术后1年复发,瘤栓转移至右心房及右心室再次术后2年无复发。结论:子宫IVL是具有恶性肿瘤生物学特性的良性病变,提高术中确诊率、彻底切除原发和转移病灶以及术后全面随诊有利于改善预后。
Objective: To investigate the clinical features of uterine venous leiomyomatosis (IVL). Methods: The clinical and pathological data of 9 cases of uterine IVL diagnosed and treated from 2004-04-2008-05 were retrospectively analyzed. Results: Of the 9 patients with IVL, 7 patients complained of pelvic mass, 1 patient had prolonged menstrual flow, 1 patients had abdominal pain, 7 patients had pelvic mass exceeding the size of 12-week pregnant uterus, the largest reached the size of 20 weeks of pregnancy, Total resection and uterine fibroids were removed after surgery in each of the 1 case; 8 cases of uterine fibroids uterine fibroids, pelvic solid tumors in 1 case, 5 cases of uterine fibroids in blood flow, of which 2 cases of blood flow was dendritic, No diagnosis of IVL before surgery. All patients underwent surgical treatment. Four patients underwent hysterectomy and bilateral accessory resection, four underwent hysterectomy and one underwent pelvic tumor resection. One patient had a recurrence one year after resection of the uterus and double attachments, and no tumor recurrence occurred after two years of tumor metastasis to right atrium and right ventricle. Conclusion: Uterine IVL is a benign lesion with malignant biological characteristics. It is helpful to improve the prognosis of patients with uterine IVL by improving the rate of intraoperative diagnosis, thorough resection of primary and metastatic lesions and comprehensive follow-up.