摘要
目的对分泌雄激素的卵巢性索间质瘤(sex cord stromal tumor,SCST)患者的诊治资料进行分析,总结其临床特征。方法回顾性分析近年来解放军总医院第一医学中心收治的10例经病理证实为分泌雄激素的SCST患者的临床资料。结果1)一般资料:10例女性患者,年龄13~69岁,病程1~6年。2)首诊情况及临床表现:5例首诊于内分泌科,5例首诊于妇科;7例青春期及育龄期女性因月经稀发或继发闭经首诊,3例绝经后女性因男性化表现首诊。临床表现:10例女性患者中,8例多毛,3例痤疮,5例嗓音改变,5例阴蒂肥大,2例脱发。3)睾酮水平:术前睾酮3.90~44.07 nmol/L,术后第2天复查睾酮0~6.51 nmol/L,较前明显下降。4)影像学表现:10例患者,其中8例通过妇科超声发现卵巢占位,2例无影像学证据,最终经手术探查确诊。5)病理:10例均为单侧卵巢肿物,直径为0.7~8.0 cm。病理结果均支持卵巢性索间质瘤,其中2例为Leydig细胞瘤,3例为黄体瘤,2例为非特异性类固醇细胞瘤,2例为支持-间质细胞瘤,1例为粒层细胞瘤。结论对于存在显著高雄激素血症的女性患者,需注意卵巢性索间质瘤可能,手术切除肿瘤可消除高雄激素临床表现。
Objective To analyze and summarize the clinical features of androgen-secreting ovarian sex cord stromal tumors(SCST).Methods Clinical data about 10 female patients with androgen-secreting SCST who were confirmed by postsurgical pathology in the First Medical Center of Chinese PLA General Hospital in recent ten years were retrospectively analyzed.Results Ten female patientsaged 13 to 69 years old were enrolled in this study,with disease course of 1 to 6 years.Five patients firstly consulted in endocrinology department,and the other 5 cases were in gynecology department.Seven patients mainly presented with oligomenorrhea or secondary amenorrhea,and 3 patients with masculinization.Clinical features included hairiness(8/10),acne(3/10),voice change(5/10),clitorism(5/10),and trichomadesis(2/10).The preoperative testosterone level ranged from 3.90 nmol/L to 44.07 nmol/L,and it significantly reduced to 0-6.51 nmol/L at the second day after operation.The ovarian tumors were detected in eight patients by gynecological ultrasound,and in the other two patients by surgical exploration.Pathology results showed that all these ten ovarian sex cord stromal tumors were unilateral with diameter ranging from 0.7 cm to 8.0 cm.The tumors included Leydig cell tumors(2/10),stromal luteomas(3/10),nonspecific steroid cell tumors(2/10),sertoli-stromal cell tumors(2/10),and granulosa cell tumor(1/10).Conclusion For female patients with obvious hyperandrogenemia,the possibility of SCST should be considered.Such clinical presentation can be eliminated with successful surgery.
作者
王美荣
王先令
郭清华
陈予龙
王敏
窦京涛
巴建明
谷伟军
吕朝晖
陆菊明
母义明
WANG Meirong;WANG Xianling;GUO Qinghua;CHEN Yulong;WANG Min;DOU Jingtao;BA Jianming;GU Weijun;LYU Zhaohui;LU Juming;MU Yiming(Department of Endocrinology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,Cangzhou People's Hospital,Cangzhou 061000,Hebei Province,China;The 3rd Special Ward,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2020年第7期679-682,共4页
Academic Journal of Chinese PLA Medical School
基金
国家自然基金面上项目(81570705)
海南省重点研发项目(ZDYF2018117,ZDYF2018130)
三亚科技创新项目(2017YW16,2016YW31,2016YW16)
海南省卫计委课题(15A200071)
