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中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 733 -734. doi: 10.3877/cma.j.issn.1674-392X.2022.06.028

病例报告

右侧子宫圆韧带平滑肌瘤误诊为腹股沟斜疝一例
罗京1, 孙岩波1,(), 岑云云1, 徐鹏远1   
  1. 1. 650101 昆明医科大学第二附属医院胃肠外科
  • 收稿日期:2022-04-27 出版日期:2022-12-18
  • 通信作者: 孙岩波
  • 基金资助:
    云南省外科临床营养研究中心基金项目(2017NS302)

A case of right round ligament leiomyoma misdiagnosed as indirect inguinal hernia

Jing Luo1, Yanbo Sun1(), Yunyun Cen1   

  • Received:2022-04-27 Published:2022-12-18
  • Corresponding author: Yanbo Sun
引用本文:

罗京, 孙岩波, 岑云云, 徐鹏远. 右侧子宫圆韧带平滑肌瘤误诊为腹股沟斜疝一例[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 733-734.

Jing Luo, Yanbo Sun, Yunyun Cen. A case of right round ligament leiomyoma misdiagnosed as indirect inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 733-734.

腹股沟疝作为腹部外科常见疾病之一,人群发病率为1%~5%,全世界每年实施2000余万台次腹股沟疝修补术,女性约占10%[1,2,3]。诊断通常可以通过病史和体格检查确定,当有不典型症状或缺乏明确体征表现时应进一步完善腹部超声、CT或MRI检查[4]。由于女性腹股沟管内有子宫圆韧带通过,因此圆韧带囊肿、脂肪瘤、平滑肌瘤、肉瘤等常与腹股沟疝相混淆,其表现均可为腹股沟区无痛性肿物,同时也可伴有指压还纳感,造成术前诊断困难甚至误诊[5,6,7,8]。现将一术前诊断为腹股沟疝的子宫圆韧带平滑肌瘤病例情况及处理报道如下。

图2 术前CT平扫见包块似肠管样结构,大小约4 cm×3 cm×2.5 cm
图4 包块标本呈灰白色,长柱状,远端稍大,质韧,血供良好,切开见编织状结构
图6 免疫组化DAB染色(100×):SMA(+)、Caldesmon(+)、Vim(+)、desmin(+)、bcl-2(-)、Ki67(3%),提示平滑肌瘤梭形平滑肌细胞,呈编织状排列,提示平滑肌瘤
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