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患者,73岁。于1991年7月11日收入院。3个月前发现下腹部拳头大包块,近一个月生长迅速,并感下腹隐痛,坠胀不适,尿急,尿频,便秘。绝经已25年。妇科检查:宫体大小触不清,其上方触及约22cm×12cm×10cm实性包块,质硬,活动度差,表面高低不平,有轻度压痛,阴道后穹窿可触及结节状物。阴道细胞涂片未见瘤细胞。肛诊:直肠粘膜光滑。X线及B超检查诊断:盆腔内肿瘤。临床诊断:盆腔肿瘤恶变?剖腹探查:血性腹水约2000ml,宫体正常大小。双侧卵巢增大,左侧卵巢表面呈菜花状,肿瘤与输卵管分界清楚,右侧卵巢肿瘤与输卵管不易分离,肿瘤无包膜,触之出血,与子宫、肠壁及周围组织广泛粘连,并侵及膀胱、直肠、大网膜。切除双侧附件送病理检查,于腹腔内灌注噻(口替)
Patient, 73 years old. In July 11, 1991 income court. 3 months ago found the lower abdomen fist mass, nearly a month of rapid growth, and feel abdominal pain, bulge discomfort, urgency, frequent urination, constipation. Menopause has 25 years. Gynecological examination: Palace body size touch, above the touch of about 22cm × 12cm × 10cm solid mass, hard, poor mobility, uneven surface, mild tenderness, vaginal posterior fornix can reach the nodules. Vaginal cell smear no tumor cells. Rectal examination: rectal mucosa smooth. X-ray and B-ultrasound diagnosis: pelvic tumor. Clinical diagnosis: malignant pelvic tumors? Caesarean exploration: bloody ascites about 2000ml, normal body size. Ovarian enlargement on both sides of the ovary, cauliflower-like surface of the ovary, tumor and tubal demarcation is clear, the right ovarian tumor and fallopian tube is not easy to separate the tumor non-enveloped, bleeding, with the uterus, intestinal wall and surrounding tissue extensive adhesions and Invasion and bladder, rectum, omentum. Removal of bilateral attachments to send pathological examination, intraperitoneal injection of thiophene (mouth replacement)