原发部位在子宫肌层的卵泡膜细胞瘤一例

Primary Thecoma Arising in the Uterine Myometrium: A Case Report

摘要: 卵泡膜细胞瘤(thecomas)通常为卵巢性索间质肿瘤，罕见于卵巢外部位。本文报告一例原发性颗粒细胞瘤发生于49岁绝经后女性子宫肌层的病例。患者因偶然发现的腹部肿块就诊，无特异性症状。超声检查显示子宫前壁肌层见两个实性低回声团，最大者尺寸为110 mm × 73 mm × 90 mm。最初诊断为子宫平滑肌瘤。手术过程中，发现子宫内肿块呈黄色，质地松软。手术标本送冰冻病理检查，回报：间叶源性肿瘤，最终病理检查回报：泡膜细胞瘤。此病例提醒我们，绝经后出现的子宫大肿块可能是其他组织来源的罕见肿瘤。

Abstract: Thecomas are typically ovarian sex cord-stromal tumors that rarely occur in extraovarian locations. We report a case of primary thecoma arising in the uterine myometrium of a 49-year-old postmenopausal woman. The patient presented with an incidentally discovered abdominal mass without specific symptoms. Ultrasound examination revealed multiple hypoechoic masses in the myometrium, with the largest measuring 110 mm × 73 mm × 90 mm. Initially diagnosed as a uterine leiomyoma. During surgery, an intramural uterine mass was identified, which appeared yellow in color and friable in consistency. The surgical specimen was submitted for pathological examination, which confirmed the diagnosis of thecoma. This case reminds us that the large mass of the uterus that appears after menopause may be a rare tumor of other tissue origins.