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題名 | Obturator Mononeuropathy: A Rare Clinical Presentation of Ovarian Cancer=單一閉孔神經病變:罕見之卵巢癌臨床表徵 |
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作者 | 賴鴻政; 柯秋松; 劉杭生; 劉嘉燿; Lai, Hung-cheng; Ke, Chiou-sung; Liu, Hang-sheng; Liu, Jah-yao; |
期刊 | 中華民國婦產科醫學會會刊雜誌 |
出版日期 | 19980900 |
卷期 | 37:3 1998.09[民87.09] |
頁次 | 頁99-102 |
分類號 | 417.25 |
語文 | eng |
關鍵詞 | 單一閉孔神經病變; 卵巢癌; Obturator mononeuropathy; Ovarian cancer; |
中文摘要 | 背景:卵巢癌極少以神經學的症狀表現。 病例報告:一位 49 歲未停經婦女因大腿前內側酸麻及疼痛,服用止痛藥及接受針灸治療數 月之久,未見改善,後因下腹不適求診於本院婦產科門診。超音波發現左側卵巢有一個六公 分看似良性的腫瘤,血清中 CA-125<35 IU/ml。病患接受經陰道全子宮及兩側卵巢輸卵管切 除手術治療後,大腿酸麻疼痛情形未見改善。手術當時冰凍切片顯示腫瘤為良性,最終報告 卻為惡性的腺癌。因此病人再接受剖腹探查,發現腹膜上有微粒樣的腫瘤,左側閉孔神經被 一串腫大的淋巴節所包覆。手術後,病患腿部症狀立即獲得改善。 結論:若一骨盆腔腫瘤合併有單一閉孔神經病變或其他腰薦神經叢病變,即使腫瘤的體積不 大,腫瘤標記的指數也不高,仍要懷疑是否有惡性腫瘤的可能。 |
英文摘要 | Background: Ovarian cancers presenting with neurological complications are rare. We report a case of ovarian cancer presenting with obturator mononeuropathy. Case Report: A premenopausal woman experienced pain over the anteromedial aspect of her left thigh. She was treated with acupuncture and analgesics, but both were administered in vain. Pelvic sonography disclosed a benign-looking tumor about 6 × 4 × 3.5 cm �� at the left overy and multiple small intramural myoma-like nodules. Total vaginal hysterectomy and bilateral salpingo-oophorectomy were performed. The pathology revealed adenocarcinoma of the ovary with myometrial invasion which was not diagnosed by the frozen section study. Postoperatively, the leg pain persisted. Subsequent staging laparotomy disclosed that the left obturator nerve was enclosed by a chain of enlarged lymph nodes, which were removed at lymphadenectomy. After the surgery, the patient was free from the symptoms. Conclusion: Despite its small size, a pelvic tumor accompanied by obturator mononeuropathy or other lumbosacral plexopathy may raise the suspicion of a pelvic malignancy. |
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