腹膜偽黏液瘤源自成熟性畸胎瘤合併邊緣性黏液性卵巢腫瘤：病例報告暨文獻回顧

Pseudomyxoma peritonei from mature cystic teratoma and borderline mucinous ovarian tumor: A case report and literature review

腹膜偽黏液瘤 (pseudomyxoma peritonei) ，一般好發於五十到七十二歲，是一個罕見的臨床病理現象， 特徵為黏液性的腹水以及病理發現黏液的上皮腫瘤細胞。此個案為一個52歲女性因為腹部逐漸脹大而轉診來到本院接受手術治療，手術中發現了一個巨大的卵巢腫瘤以及腹腔內約20公升的黏液性腹水，病理報告為腹膜偽黏液瘤源自成熟性畸胎瘤合併邊緣性的黏液性卵巢囊腫。此病症主要的臨床表現為腹部脹痛，腹圍增加，食慾不振等，嚴重時可導致噁心嘔吐以及呼吸急促等情形。腹膜偽黏液瘤的診斷主要以手術發現以及病理報告為主。術前診斷除了腫瘤指標之外，腹部的電腦斷層為目前首選的影像工具。另外手術中的發現以及病理學的免疫染色可以幫助我們鑑別腫瘤的來源。在治療方面目前還是以手術的方式來解除病患的症狀，並可以考慮加做加熱式的腹膜內化學治療以降低復發機率，但病人要承擔的副作用也相對提高。低惡性度的卵巢腹膜偽黏液瘤有較低的復發機率，但缺乏足夠案例數量且長期追蹤的資料有限。腹膜偽黏液瘤在卵巢腫瘤的預後是否與腸胃道或是闌尾腫瘤相同，還有待日後考證。

Pseudomyxoma peritonei characterized by mucinous ascites with pathologicalfindings of mucinous epithelial tumor cells is a rare clinical pathological syndrome. A 52-year-old woman had complained of abdominal fullness and progressively increased abdominal circumference. After a series of examination, exploratory laparotomy was performed. Operative findings showed a large ovarian tumor accompanied with 20 liters of jelly-like acites. Adequate cytoreductive surgery was done, and the pathology revealed pseudomyxoma peritonei originated from right ovary with mixed mature cystic teratoma and mucinous borderline ovarian tumor. Based on this case report, a brief review of pseudomyxoma peritonei was done.