گزارش يك مورد تورشن فيبروماي تخمدان همراه با آسيت و افيوژن پلور: گزارش موردي

A case report of ovarian fibroids torsion with ascites and pleural effusion: case report

معرفي بيمار: بيمار زن 65 ساله منوپوز با شكايت درد شكمي، فروردين 1397 به مركز دانشگاهي امام رضا (ع) مشهد مراجعه كرد. در معاينه شكم، توده‌ي 200×100 ميليمتري با قوام نرم لمس شد. در آزمايشات، لكوسيتوز و CA125 بالاتر از 200 بود. در تصوير قفسه صدري افيوژن پلورال دوطرفه گزارش و در سي‌تي اسكن كانون هتروژن 170×100 ميلي‌متري لبوله با منشا آدنكس راست با انهنسمنت (Enhancement) ضعيف ديده شد. در لاپاراتومي تجسسي آسيت فراوان مشهود بود. امنتوم ملتهب سطح تخمدان راست را پوشانده و توده حجيم ساليد-كيستيك، نامنظم، لبوله و محصور درون كپسول در محل آدنكس راست ديده شد. سالپنگواووفوركتومي راست انجام و نتايج آسيب‌شناسي ضايعات پروليفراتيو خوش‌خيم سلول‌هاي فيبروبلاست بدون ميتوز منطبق بر فيبروم تخمداني را گزارش كرد.

Background: Ovarian fibroma is the most common benign solid tumor of the ovary. The most common symptoms are abdominal discomfort and pain. Ovarian fibroids are associated with Meigs syndrome in 1% to 10% of cases. The aim of study is report of a case of Meigs syndrome Case presentation: A 65-year-old menopausal woman who complained of abdominal pain was referred to our academic hospital of Mashhad, Iran, in April 2018. In abdominal examination, a soft mass with size of 200×100 mm, was detected. Also leukocytosis and increase in CRP was observed. Marker CA125 was higher than 200. In CT scan in right adnexa heterogeneous mass 170×100 mm with enhancement was reveled. pleural effusion was reported in the both lungs and collapse of underlying lung tissue in Chest X-ray. Explorative laparotomy was performed. Ascites and inflamed omentum covered the surface of right ovary was detected. The huge solid-cystic hemorrhagic, irregular mass with a specific pedicle that enclosed in the capsule in right adnexa was seen. Right salpingo-oophorectomy was performed. The result of final pathologic was benign proliferative lesions of mitotic fibroblasts were reported according to ovarian fibroma. Conclusion: In case of accompanying ovarian mass with ascites and pleural effusion, after the exclude of ovarian malignancies, Meigs syndrome should be considered in differential diagnosis.