摘要
目的 探讨原发性输卵管绒毛膜癌误诊为输卵管妊娠的原因及防范措施。方法 对2014年7月—2020年4月收治的误诊为输卵管妊娠的原发性输卵管绒毛膜癌4例的临床资料进行回顾性分析。结果 4例均有停经史,阴道异常出血3例,下腹部隐痛3例,1例自测尿人绒毛膜促性腺激素(HCG)试验阳性。4例均误诊为异位妊娠,检测血清β-HCG>10 000 U/L,手术切除病灶组织送病理检查确诊为原发性输卵管绒毛膜癌。术后给予5-氟尿嘧啶+放线菌素D联合化疗,血清β-HCG转阴,随访20~24个月无复发。结论 原发性输卵管绒毛膜癌易误诊为输卵管妊娠。临床对于疑似异位妊娠,且血清β-HCG>10 000 U/L的患者,应警惕输卵管绒毛膜癌,以尽早诊断,及时治疗。
Objective To explore the causes of misdiagnosis of primary tubal choriocarcinoma as tubal pregnancy and preventive measures.Methods The clinical data of 4 patients with primary choriocarcinoma of tubal tube misdiagnosed as tubal pregnancy from July 2014 to April 2020 were retrospectively analyzed.Results All the 4 cases had a history of menopausal,3 cases had abnormal vaginal bleeding,3 cases had dull pain in the lower abdomen,and 1 case had positive human chorionic gonadotrophin(HCG)test.All 4 cases were misdiagnosed as ectopic pregnancy,serumβ-HCG>10000 U/L was detected,and primary choriocarcinoma of tubal tube was confirmed by surgical resection and pathological examination.After 5-Fluorouracil+Actinomycin D combined chemotherapy,the bloodβ-HCG turned negative,and no recurrence was reported during 20-24 month follow-up.Conclusion Primary tubal choriocarcinoma is more likely to be misdiagnosed as tubal pregnancy.For patients with suspected ectopic pregnancy,and serumβ-HCG>10000 U/L in clinical practice,tubal choriocarcinoma should be considered for early diagnosis and timely treatment.
作者
于春燕
刘静
武长芬
YU Chunyan;LIU Jing;WU Changfen(The First Department of Obstetrics,Maternal and Child Health Hospital of Shijiazhuang City,Shijiazhuang 050000,China;Department of Reproductive Medicine,Maternal and Child Health Hospital of Shijiazhuang City,Shijiazhuang 050000,China)
出处
《临床误诊误治》
CAS
2023年第6期25-27,共3页
Clinical Misdiagnosis & Mistherapy
