妊娠合并卵巢幼年型颗粒细胞瘤病例回顾并文献复习

Pregnancy with Ovarian Type Juvenile Granulosa Cell Tumor: Retrospective Analysis of Clinical Cases and Literature Review

摘要: 目的：分析妊娠合并幼年型颗粒细胞瘤(juvenile granulosa cell tumor, JGCT)的临床特点、诊断要点、治疗及预后，提高诊断水平。方法：回顾性分析一例妊娠合并JGCT患者的诊治经过，并复习国内外发表的6例病例报道。结果：患者29岁，孕2产1，因“停经39 + 6周，发现羊水减少半天”入院，入院完善检查后行球囊引产失败，遂急症剖宫产术分娩一健康男婴，术中见左侧卵巢一大小约4.0 * 3.0 cm囊实性肿物，行子宫下段横切口剖宫产术 + 左侧卵巢囊肿剥除术，术后病理回报：符合幼年型颗粒细胞瘤。患者因个人因素拒绝行二次手术。结论：妊娠合并早期卵巢幼年型颗粒细胞瘤非常罕见，术前诊断困难，目前确诊依据组织病理及免疫组织化学染色检查，治疗首选手术治疗。

Abstract: Objective: To analyze clinical features, diagnosed key points, treatment and prognosis of ovarian type juvenile granulosa cell tumor (JGCT) during pregnancy in order to improve the level of diagnosis. Methods: To retrospectively analyze a case of pregnancy with JGCT and review relevant literatures. Other six patients’ clinical manifestations were summarized, and related literatures were reviewed. Result: A 29-year-old female patient, G2P1, was admitted for menolipsis after 39 + 6 weeks, and amniotic fluid decreased by half a day. A normal healthy baby was delivered. Emergency cesarean delivery and exploratory laparotomy were carried out after balloon induction failure. A 4.0 * 3.0 cm cystic solid mass was founded in the left ovary, resection of the left ovarian mass was performed and the postoperative pathological diagnosis was JGCT. The patient refused treatment for social reasons. Conclusion: Pregnancy with JGCT is rare and difficult to diagnose. The diagnosis depends on pathological and immunohistochemical staining, and surgical treatment is the first choice.