PDF(Pubmed)
Abstract：
Atypical placental site nodule (APSN) is a rare benign gestational trophoblastic disease (GTD). It is a tumor-like transformation that has a certain probability of developing into a placental site trophoblastic tumor (PSTT) or epithelioid trophoblastic tumor (ETT). Because of its atypical clinical presentation, it is difficult to diagnose and susceptible to misdiagnosis highly, thus delaying the patient\'s condition. We report a scarce case of atypical nodules at the placental site of the uterine incision diverticulum in a 35-year-old female, who was irregular vaginal bleeding after a cesarean Sect. 2 years. She was diagnosed by several local hospitals with intrauterine residue and was given a variety of Traditional Chinese Medicine (TCM) orally, but the symptoms of irregular vaginal bleeding have not been alleviated. After being transferred to several hospitals, she went to Hubei Maternal and Child Health Hospital for treatment. Under the condition of excluding the second pregnancy, she underwent hysteroscopic resection of lesions and laparoscopic repair of uterine incision diverticulum. The pathological diagnosis after the operation suggested that the focus at the uterine incision was an atypical placental nodule that invaded the myometrium of the uterus. The operation completely removed the focus, and then the patient was followed up every 3 months in the first postoperative year, then every 6 months up to 3 years, and then annually thereafter up to 5 years, and then maybe every 2 years thereafter. The patient\'s condition was quickly controlled, and the prognosis was good.
摘要：
不典型胎盘部位结节(APSN)是一种罕见的良性妊娠滋养细胞疾病(GTD)。它是一种肿瘤样转化，具有一定的发展为胎盘部位滋养细胞肿瘤（PSTT）或上皮样滋养细胞肿瘤（ETT）的可能性。由于其不典型的临床表现，诊断困难，极易误诊，从而延迟了病人的病情。我们报告了一名35岁女性子宫切口憩室胎盘部位的非典型结节的罕见病例，剖宫产术后阴道不规则出血.2年。她被当地几家医院诊断为宫内残留物，并口服了多种中药（TCM），但是不规则阴道出血的症状没有得到缓解。在被转移到几家医院后，到湖北省妇幼保健院治疗。在排除第二次怀孕的情况下，行宫腔镜下病灶切除术和腹腔镜下子宫切口憩室修补术。术后病理诊断提示子宫切口病灶为不典型胎盘结节，侵入子宫肌层。该操作完全消除了焦点，术后第一年每3个月随访一次,然后每六个月到三年，然后每年长达5年，然后可能每隔两年。病人的病情很快得到控制,预后良好。
