Recurrence of Ovarian Cancer with Placental Metastasis: A Case Report.
Recurrence of Ovarian Cancer with Placental Metastasis: A Case Report.
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DOI：
10.1159/000479959
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发表时间：
2017-09
影响因子：
0.8
通讯作者：
Sugimoto M
中科院分区：
文献类型：
--
作者：
Honda M;Yamada M;Kumasaka T;Samejima T;Satoh H;Sugimoto M
一位39岁的初产日本女性，在另一家医院剖腹产后不久，因大量胸腔积液引起的呼吸窘迫而住进了本院的产科急诊科。当她接受CD检查时，发现了一个巨大的卵巢肿瘤。然而，肿瘤无法在该设施切除，她被转移到我们医院。CD三天后，行左侧输卵管卵巢切除术，以控制胸腔和腹膜积液。根据她过去的治疗史和从这次手术中收集的信息，卵巢癌的复发被认为是最终诊断。早些时候，在37岁时，她被诊断为IC期卵巢腺癌，源于右侧输卵管卵巢切除术后发现的成熟囊性畸胎瘤。这种在急诊科意外发现新孕患者复发的晚期卵巢癌的情况很少见。其中，我们发现了一例极罕见的胎盘转移病例。从这一案例报告中吸取的重要教训是，当孕妇在没有转诊函的情况下就诊时，特别是在怀孕后期，详细的医学面谈和体检是至关重要的。
A 39-year-old primiparous Japanese female was admitted to the obstetrical emergency department of our hospital because of respiratory distress resulting from a large amount of pleural effusion, soon after a caesarean delivery (CD) at another hospital. While she was undergoing the CD, a giant ovarian tumour was identified. However, the tumour could not be removed at that facility and she was transferred to our hospital. Three days after the CD, a left salpingo-oophorectomy was performed with the purpose of controlling pleural and peritoneal effusions. Based on her past treatment history and the information gathered from this surgery, recurrence of ovarian cancer was considered the final diagnosis. Earlier, at the age of 37 years, she had been diagnosed with stage IC ovarian adenocarcinoma arising from a mature cystic teratoma detected after a right salpingo-oophorectomy. These kinds of situations of accidental detection of recurrent advanced ovarian cancer in a newly pregnant patient in the emergency department are rare. Amongst them, we have identified an extremely rare case showing placental metastasis. The important lesson learnt from this case report is that detailed medical interviews and physical examinations are crucial when a pregnant woman visits a hospital without a letter of referral, especially in the third trimester of pregnancy.