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患者女,19岁。无明显诱因右上腹痛1天,呈阵发性,伴恶心,无呕吐。患者7个月前因“左侧卵巢畸胎瘤”行手术治疗。10余天前超声检查示(肝内)巨大囊实性占位,大小约12.2 cm×10.3 cm,边界不清,形态欠规则(图1)。体检:右上腹局限性隆起,可触及一直径约15 cm包块,质硬,光滑,不活动,有压痛。实验室检查:肝、肾功能正常,甲胎蛋白明显升高(154.10μg/L)。CT表现:右上腹肝膈见一巨大囊实性分叶状
Female patient, 19 years old. No obvious incentive 1 day right upper quadrant pain, was paroxysmal, with nausea, no vomiting. Patients 7 months ago due to “left ovarian teratoma ” line surgery. Ultrasound examination more than 10 days ago showed the huge cystic solid mass, about 12.2 cm × 10.3 cm in size, with unclear boundaries and irregular morphology (Figure 1). Physical examination: limitations of the right upper quadrant bulge, palpable diameter of about 15 cm mass, hard, smooth, inactive, tenderness. Laboratory tests: liver and kidney function was normal, a-fetoprotein was significantly elevated (154.10μg / L). CT performance: the right upper quadrant of the diaphragm to see a huge cystic solid lobulation