妊娠晚期巨大卵巢卵黄囊肿瘤:病例报告和文献综述

IF 3.5 3区 医学 Q2 ONCOLOGY Frontiers in Oncology Pub Date : 2024-09-06 DOI:10.3389/fonc.2024.1437728
Qin Wang, Jianxin Zuo, Chong Liu, Huansheng Zhou, Wenjie Wang, Yankui Wang
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引用次数: 0

摘要

在妊娠晚期出现巨大卵巢卵黄囊肿瘤的情况较为罕见。卵黄囊肿瘤是一种起源于原始生殖细胞的高度恶性生殖细胞肿瘤。其特征是卵黄囊在体外分化。对于孕期发现的卵巢肿瘤,应适当增加产前检查的频率。此外,应定期进行超声随访,动态检测肿瘤标志物。必要时,应结合计算机断层扫描和磁共振成像等影像学检查,全面了解疾病进展情况。如果妊娠期肿瘤直径和肿瘤标志物水平迅速增加,恶性肿瘤的可能性就会增加。因此,应立即进行探查性剖腹探查术,以进一步改善后续治疗方式、早期诊断、早期治疗和预后。在此,我们报告了一例 28 岁孕妇的病例,她在妊娠 29 周零 5 天时终止妊娠。她主诉下腹痛 2 天。1 周后发现盆腔肿块,同时血清甲胎蛋白、癌抗原 125、碳水化合物抗原 724 和人类附睾蛋白 4 等肿瘤标志物水平升高。在怀孕 32 周零 3 天时,进行了剖腹产手术,在子宫下段做了横切口。此外,还进行了盆腔粘连切除术、卵巢切除术、右侧附件切除术、右侧盆腔淋巴结清扫术和盆腔转移腹膜切除术。术后病理诊断为卵巢卵黄囊肿瘤(IIB期)。术后,患者接受了由博来霉素、依托泊苷和顺铂组成的五周期化疗。术后随访期间,患者的总体状况良好,新生儿和孕妇最终都获得了良好的治疗效果。我们回顾了相关文献,以提高临床医生对妊娠期卵巢恶性肿瘤的认识,指导治疗选择,并促进对相关疾病的早期干预。
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Giant ovarian yolk sac tumor during late pregnancy: a case report and literature review
The manifestation of a giant ovarian yolk sac tumor during late pregnancy is relatively rare. A yolk sac tumor is a highly malignant germ cell tumor that originates from primitive germ cells. It is characterized by yolk sac differentiation in vitro. The frequency of prenatal examinations should be appropriately increased for ovarian tumors discovered during pregnancy. Furthermore, regular follow-up ultrasound should be performed, and tumor markers should be dynamically detected. If needed, imaging examinations such as computed tomography and magnetic resonance imaging should be combined to comprehensively investigate disease progression. If the tumor diameter and tumor marker levels rapidly increase during pregnancy, the possibility of malignancy increases. Therefore, exploratory laparotomy should be immediately performed to further improve subsequent treatment modalities, early diagnosis, early treatment, and prognosis. Herein, we report the case of a 28-year-old pregnant woman whose pregnancy was terminated at 29 weeks and 5 days. She complained of lower abdominal pain for 2 days. A pelvic mass was detected for 1 week, accompanied by increased levels of tumor markers such as serum alpha-fetoprotein, cancer antigen 125, carbohydrate antigen 724, and human epididymis protein 4. Imaging revealed the presence of a pelvic mass. At 32 weeks and 3 days of pregnancy, a cesarean section was performed, with a transverse incision in the lower uterine segment. Furthermore, pelvic adhesiolysis, omentectomy, right adnexectomy, right pelvic lymph node dissection, and pelvic metastasis peritonectomy were performed. The postoperative pathological diagnosis was yolk sac tumors of the ovary (stage IIB). Postoperatively, a five-cycle chemotherapy regimen comprising bleomycin, etoposide, and cisplatin was administered. During postoperative follow-up, the patient’s general condition was noted to be good, with the newborn and pregnant women ultimately achieving good outcomes. We reviewed the relevant literature to increase clinical doctors’ understanding of ovarian malignancy during pregnancy, guide treatment selection, and facilitate early intervention for associated diseases.
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来源期刊
Frontiers in Oncology
Frontiers in Oncology Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
6.20
自引率
10.60%
发文量
6641
审稿时长
14 weeks
期刊介绍: Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.
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