Large pelvic mass arising from the cervical stump: A case report
Large pelvic mass arising from the cervical stump: A case report
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宫颈残端引起的盆腔大肿块一例报告
DOI：
10.12998/wjcc.v8.i1.149
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发表时间：
2020-01-06
影响因子：
1.1
通讯作者：
Xue, Feng-Xia
中科院分区：
文献类型：
--
作者：
Zhang, Kai;Jiang, Jing-Hong;Xue, Feng-Xia
背景：一个巨大的宫颈囊肿，同时伴有宫颈高度鳞状上皮内病变，起源于宫颈残端是很少见的。子宫颈上切除术后，有各种病变发生在宫颈残端的风险。我们回顾子宫颈残端病变的类型和特点，并比较全子宫切除术和次全子宫切除术。妇科医生应根据患者的病情和意愿选择最合适的手术方式。如果子宫颈保留，患者需要密切following.CASE摘要一个57岁的女子被送往妇科一个大的盆腔肿块。她主诉腹胀两个月。14年前，她曾因子宫平滑肌瘤接受子宫颈上次全切除术。腹部超声检查发现盆腔内有一个9.1 cm x 8.5 cm x 8.4 cm的无回声肿块，伴银色液体，高危型人乳头状瘤病毒53（HPV53）阳性。我们首先考虑的入院诊断是类似于宫颈残端癌的盆腔肿块。我们进行剖腹手术，快速冷冻活检提示纤维囊肿壁覆盖着高度鳞状上皮内病变。切除盆腔肿块，并实施双侧附件切除术。最后病理证实，盆腔肿块是一个巨大的炎性囊肿，伴有宫颈高度鳞状上皮内病变。手术成功后1周出院，43 mo时阴道残端无复发。结论妇科医生在处理子宫良性疾病时，应充分重视保留宫颈。如果子宫颈保留，患者需要密切随访。
BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare. After supracervical hysterectomy, there is a risk of various lesions occurring in the cervical stump. We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy. Gynecologists should choose the most suitable surgical method based on both the patient's condition and wishes. If the cervix is retained, patients require a close follow-up.CASE SUMMARY A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass. Her chief complaint was abdominal distention for two months. She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior. Abdominal ultrasonography detected a 9.1 cm x 8.5 cm x 8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53 (HPV53) was positive. The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump. We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion. The pelvic mass was removed, and a bilateral adnexectomy was implemented. Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion. After successful intervention, the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo.CONCLUSION When addressing benign uterine diseases, gynecologists should pay adequate attention to retaining the cervix. If the cervix is retained, patients require a close follow-up.