小肠平滑肌肉瘤8例误诊分析
小肠平滑肌肉瘤,,小肠平滑肌肉瘤；腹部包块；出血；影像学检查；误诊；原因,2结果,3讨论,参考文献:
摘要:目的 探讨小肠平滑肌肉瘤的临床表现、术前误诊的原因。方法 对8例小肠平滑肌肉瘤病例的临床表现、影像学检查、术前诊断、术中所见及手术方法进行总结分析。结果 术前8例均被误诊，误诊为肠套叠4例，空肠血管瘤1例，卵巢肿瘤2例，盆腔肿瘤1例；8例均经术后病理检查证实为小肠平滑肌肉瘤。1例行胰十二指肠切除术，4例行根治性小肠平滑肌肉瘤切除术，其余3例因侵犯广泛而无法切除。4例术后2年内死亡，其余4例目前仍存活，无复发。结论 小肠平滑肌肉瘤缺乏特征性的临床表现而常常被误诊，影像学检查有助于术前诊断，手术切除是目前唯一有效的根治性治疗方法。关键词:小肠平滑肌肉瘤；腹部包块；出血；影像学检查；误诊；原因
Misdiagnosis analysis of 8 cases with small intestinal leiomyosarcoma
HE Bohua,QIAN Jubiao,XIAO Lanfeng
(Section of Surgery,Guangdong College of Pharmacy,Guangzhou,510006，China)
Abstract: Objective To investigate the clinical manifestations,the cause of preoperative misdiagnosis of small intestinal leiomyosarcoma. Methods Clinical findings,imaging examinations,preoperative diagnosis,intraoperative findings and operative styles of 8 cases with small intestinal leiomyosarcoma were analyzed retrospectively. Results All of the 8 cases were misdiagnosed preoperatively. 4 cases were misdiagnosed as intussusception,1 case as jejunal haemangioma, 2 cases as ovarian tumor and 1 case as pelvic tumor. Pathological diagnoses of those 8 cases were confirmed postoperatively as small intestinal leiomyosarcoma. 1 patient underwent pancreatoduodenectomy,4 patients underwent radical resection of small intestinal leiomyosarcoma. The tumors of the other 3 patient were not been removed because of extensive invasion. 4 cases died in the duration of two years after operation. The other 4 cases are still alive without evidence of recurrence. Conclusion Lack in characteristic of clinical manifestations of small intestinal leiomyosarcoma usually causes a preoperative misdiagnosis. Imaging examinations are significant for its preoperative diagnosis. Resection is the unique effective means for the radical treatment of small intestinal leiomyosarcoma. ......
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