| Purpose:We analyze the characteristics of 25 cases of patients with retroperitoneal tumors found in gynecological exploration operation,for improving the understanding of retroperitoneal tumors and avoiding misdiagnosis as gynecological tumors.Materials and methods:We collect clinical data of 25 patients who first misdiagnosed as gynecologic oncology patients with retroperitoneal tumors in the second hospital of Jilin University from January 2009 to December 2016 were found during the operation by gynecologist and proved by pathology.The data of medical history,auxiliary examination and pathological diagnosis were retrospectively analyzed.Result:1.25 patients were collected and their ages were from 19 to 69,with an average age of 45.4+13.32 years old,of which 40-60 years old patients were the most,accounting for 60%.2.In this group,15 patients discovered pelvic mass in a physical examination.The other patients clinical performance were palpable abdominal mass?abdominal pain?abdominal distension?low back pain?frequent urination,left lower limb pain?dysmenorrhea?vaginal bleeding.3.Of all the 25 patients were examined by color doppler ultrasound.3 cases was examined by CT and 1 case were examined by MRI.Inaddition to 2 cases of patients considered uterine fibroids before surgery not performed tumor markers,the others were examined with gynecological tumor markers which were in the normal range.4.The location of the tumors are all in the pelvic retroperitoneal region,18 cases close to the bladder ? rectum and uterus,5 near the internal and external iliac artery and vein and 1 near the abdominal aorta;the largest tumor volume was 18cm*14cm*10cm,the minimum volume of 4cm*4cm*3cm,4 cases of malignant tumor diameter over 10cm;23cases of solitary tumor,2 cases of multiple.5.All 25 patients underwent surgicaltr eatment.19 patients were completely resected whose tumor capsule is integrated and did not invasion of adjacent organs and blood vessels;5 cases were partially resected and 1 patient'tumor near the abdominal aorta having a risk on surgical were only performed pelvic tumor biops.6.In this group,21 cases were benign,including 7 cases of leiomyoma,3 cases of neurilemmoma,2 cases of Castleman disease,2cases of endometriosis,inflammatory mass,lymphangiomyoma bronchitis,cysts,neurofibroma,teratoma,lipoma,paraganglioma in 1cases;4 cases were malignant,including 2 cases of liposarcoma,1 cases of inflammatory myofibroblastic tumor,1 cases of undifferentiated sarcoma.Conclusion:1.PRT rarely occur and clinical symptoms are similar to gynecological disease,it is difficult to differentiate sometimes and easily misdiagnosed as gynecological tumors.2.It is helpful for differential diagnosis that detailed collecting of the patient's history,careful physical examination and the necessary auxiliary examination.3.Imaging examination,especially color doppler ultrasound is main method to identify PRT.If color doppler ultrasound measure two normal ovarium,we should consider the possibility of retroperitoneal tumor,which suggest that it is help to determine the source of tumor that ultrasound should try to show two ovarium.4.If the ultrasound showed that the mass is too large,it should be make a CT?MRI examination to determine the location and nature of the tumor.CT,MRI has a higher diagnostic value for PRT when the tumor is large.5.Tumor markers can be used as a reference indicator.When the attachment region mass or larger pelvic mass of patients with a normal tumor markers and without ascites is considered as malignant tumor,we should consider the possibility of retroperitoneal tumor.6.CTU and painless gastroscope have a certain value for the elimination of diseases. |
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