PDF(Pubmed)
Abstract：
When a woman presents with an acute abdomen with cystic lesions in the abdominal cavity, the differential diagnosis includes torsion or rupture of an ovarian tumor. We report our experience with a 54-year-old nulliparous woman who underwent emergency surgery for a suspected ruptured ovarian tumor. Intraoperative examination revealed disruption of a cystic tumor that had developed externally from the fundus of the uterus. The patient, who was taking aspirin because of a history of medullary infarction, reported lower abdominal discomfort for several days. When she sought care, she was referred to the gynecology department where transvaginal ultrasonography and contrast-enhanced computed tomography showed a poorly toned mass with a maximum diameter of 20 cm posterior to the uterus. She also had a large amount of ascites reaching around the liver and the spleen. She underwent an emergency laparotomy for a presumed diagnosis of acute abdomen caused by a ruptured ovarian tumor with intra-abdominal bleeding. Intraoperative examination revealed normal adnexae bilaterally, but there was a cystic tumor in the pouch of Douglas that was strongly adherent to the surrounding intestines. This mass was connected to the posterior uterus by a stalk and appeared to be continuous with the uterine tissue. The postoperative pathological diagnosis was carcinosarcoma derived from subserous cystic adenomyosis. This is the first case report of carcinosarcoma developing from subserous cystic adenomyosis in the English literature as far as we know.
摘要：
当一个女人出现在腹腔囊性病变的急腹症时，鉴别诊断包括卵巢肿瘤扭转或破裂。我们报告了一名54岁的未产妇女的经验，该妇女因怀疑卵巢肿瘤破裂而接受了紧急手术。术中检查显示从子宫底外部发展的囊性肿瘤破裂。病人,因为有延髓梗塞史而服用阿司匹林的人，报告下腹部不适几天。当她寻求照顾时，她被转诊至妇科,经阴道超声检查和对比增强计算机断层扫描显示,子宫后方最大直径为20cm的肿块色调不佳.她也有大量腹水到达肝脏和脾脏周围。她接受了紧急剖腹手术，以推测诊断为由卵巢肿瘤破裂并腹腔内出血引起的急腹症。术中检查显示双侧附件正常，但是道格拉斯的囊袋中有一个囊性肿瘤，与周围的肠道强烈粘附。该肿块通过茎连接到子宫后部，并且似乎与子宫组织连续。术后病理诊断为浆膜下囊性子宫腺肌病的癌肉瘤。据我们所知，这是英文文献中第一例由浆液下囊性子宫腺肌病发展而来的癌肉瘤。
