CAJ | 학술논문

目的：探讨卵巢妊娠黄体瘤诊断、手术切除范围，避免术后过早绝经。方法从临床特征、病理形态等方面分析1例罕见巨大妊娠卵巢黄体瘤并复习文献，观察术后月经情况直至绝经后3年。结果患者28岁，2000年孕晚期时出现男性化症状，发现双侧卵巢增大至15 cm，因引产失败行剖宫产同时行双侧卵巢部分切除术，保留正常大小的卵巢。病理为双侧卵巢妊娠黄体瘤，属瘤样增生病变。术后男性化症状消失，月经正常，但39岁时绝经。结论妊娠卵巢黄体瘤罕见，为妊娠后期黄素化细胞结节状增生，非真性肿瘤，产后可自行消退。妊娠期出现卵巢明显增大而非新生物，无论是否伴有男性征时，均应首先考虑到本病的可能性。10 cm以下肿瘤仅取足够标本行快速冰冻切片检查和术后常规病理检查；瘤体巨大时至少应根据患者年龄保留卵巢达到正常体积的2倍。本例患者39岁绝经与剖宫产时双侧卵巢黄体瘤切除过多有关。
목적：탐토란소임신황체류진단、수술절제범위，피면술후과조절경。방법종림상특정、병리형태등방면분석1례한견거대임신란소황체류병복습문헌，관찰술후월경정황직지절경후3년。결과환자28세，2000년잉만기시출현남성화증상，발현쌍측란소증대지15 cm，인인산실패행부궁산동시행쌍측란소부분절제술，보류정상대소적란소。병리위쌍측란소임신황체류，속류양증생병변。술후남성화증상소실，월경정상，단39세시절경。결론임신란소황체류한견，위임신후기황소화세포결절상증생，비진성종류，산후가자행소퇴。임신기출현란소명현증대이비신생물，무론시부반유남성정시，균응수선고필도본병적가능성。10 cm이하종류부취족구표본행쾌속빙동절편검사화술후상규병리검사；류체거대시지소응근거환자년령보류란소체도정상체적적2배。본례환자39세절경여부궁산시쌍측란소황체류절제과다유관。
Objective To discuss the diagnosis of ovarian luteoma of pregnancy, and the resection range, so as to avoid postoperative early menopause.Methods One case of rare huge ovarian luteoma of pregnancy was analyzed in terms of clini-cal features and pathomorphism, and related documents were reviewed.Then the postoperative menstrual conditions were ob-served until three years after menopause.Results A patient,28 years old,began to show masculine symptoms in her third tri-mester of pregnancy in 2000.It was found that her bilateral ovaries were enlarged to 15cm.Then,a cesarean delivery was per-formed due to failure of induced labour,and part of bilateral ovaries was removed,with normal sized ovaries left.The pathology was luteoma of pregnancy in bilateral ovaries,which was a kind of tumor-like hyperplasia and lesion.After the operation, mas-culine symptoms disappeared and menstruation became normal.However,when the patient was 39,menopause developed.Con-clusion Ovarian luteoma of pregenancy is very rare,which is in fact the modular hyperplasia of luteinized cells in the latter half of gestation,rather than true tumor.It can resolve spontaneously after delivery.In gestation period, if ovaries significantly become enlarged without new neoplasm, possibility of the disease should be taken into account, regardless of the masculine symptoms.For tumors smaller than 10cm,some samples need to be taken,only for frozen section examination and postoperative routine pathological examination.For large tumors,at least twice the size of the normal ovaries should be reserved according to the patient's,age.For the patient in the case,her menopause at age 39 is related to too much removal of luteoma in bilateral o-varies during cesarean delivery.