输卵管卵巢脓肿合并甲状腺功能减退误诊为卵巢癌一例
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摘要
输卵管卵巢脓肿(tubo-ovarian abscess,TOA)是女性盆腔炎性疾病最严重的一种,患者早期表现为发热,随疾病进展逐渐演变成急腹症。甲状腺功能减退患者临床表现的严重程度取决于甲状腺激素缺乏的持续时间和程度,重者可能出现情绪和认知障碍、心脏扩大、肠梗阻、恶性贫血、体腔积液及代谢紊乱等慢性疾病。当二者共同出现时,极易误诊为晚期卵巢恶性肿瘤,进而延误治疗。本文报道1例TOA合并甲状腺功能减退误诊为卵巢恶性肿瘤患者的临床资料,以加深临床医生对此类疾病的认识,提高诊断和治疗水平。
Tubo-ovarian abscess(TOA) is one of the most serious pelvic inflammatory diseases in women.The early manifestation of the disease is fever. With the progress of the disease, it gradually evolves into acute abdomen. The severity of clinical manifestations in patients with hypothyroidism depends on the duration and severity of thyroid hormone deficiency. Severe patients may suffer from chronic diseases such as emotional and cognitive impairment, cardiac enlargement, intestinal obstruction, malignant anemia, coelomic effusion and metabolic disorders. When TOA and hypothyroidism occur together in a patient, it is easy to be misdiagnosed as the advanced ovarian malignant tumor. In this paper, we report a case of TOA combined with hypothyroidism that was misdiagnosed as malignant ovarian tumor, in order to improve the understanding, diagnosis and treatment of this complex disease.
Tubo-ovarian abscess(TOA) is one of the most serious pelvic inflammatory diseases in women.The early manifestation of the disease is fever. With the progress of the disease, it gradually evolves into acute abdomen. The severity of clinical manifestations in patients with hypothyroidism depends on the duration and severity of thyroid hormone deficiency. Severe patients may suffer from chronic diseases such as emotional and cognitive impairment, cardiac enlargement, intestinal obstruction, malignant anemia, coelomic effusion and metabolic disorders. When TOA and hypothyroidism occur together in a patient, it is easy to be misdiagnosed as the advanced ovarian malignant tumor. In this paper, we report a case of TOA combined with hypothyroidism that was misdiagnosed as malignant ovarian tumor, in order to improve the understanding, diagnosis and treatment of this complex disease.
引文
[1]Cho HW,Koo YJ,Min KJ,et al.Pelvic Inflammatory Disease in Virgin Women With Tubo-ovarian Abscess:A Single-Center Experience and Literature Review[J].J Pediatr Adolesc Gynecol,2017,30(2):203-208.
[2]Sordia-Hernández LH,Serrano Castro LG,Sordia-Pi觡eyro MO,et al.Comparative study of the clinical features of patients with a tubo-ovarian abscess and patients with severe pelvic inflammatory disease[J].Int J Gynaecol Obstet,2016,132(1):17-19.
[3]de Carvalho GA,Paz-Filho G,Mesa Junior C,et al.MANAGEMENT OF ENDOCRINE DISEASE:Pitfalls on the replacement therapy for primary and central hypothyroidism in adults[J].Eur J Endocrinol,2018,178(6):R231-R244.
[4]Baskin HJ,Cobin RH,Duick DS,et al.American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism[J].Endocr Pract,2002,8(6):457-469.
[5]黄燕明,王燕,侯洁,等.重度原发性甲状腺功能减退并复发性双侧巨大卵巢囊肿1例[J].实用妇产科杂志,2017,33(3):236-237.
[6]付淑娟,周张杰,夏晓婷,等.直肠癌术后合并甲状腺机能减退治疗后致腹腔积液一例[J].实用肿瘤杂志,2017,32(6):555-556.
[7]黎洪展.甲状腺功能减退症主要表现体腔积液1例[J].第一军医大学分校学报,2003,26(1):80.
[2]Sordia-Hernández LH,Serrano Castro LG,Sordia-Pi觡eyro MO,et al.Comparative study of the clinical features of patients with a tubo-ovarian abscess and patients with severe pelvic inflammatory disease[J].Int J Gynaecol Obstet,2016,132(1):17-19.
[3]de Carvalho GA,Paz-Filho G,Mesa Junior C,et al.MANAGEMENT OF ENDOCRINE DISEASE:Pitfalls on the replacement therapy for primary and central hypothyroidism in adults[J].Eur J Endocrinol,2018,178(6):R231-R244.
[4]Baskin HJ,Cobin RH,Duick DS,et al.American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism[J].Endocr Pract,2002,8(6):457-469.
[5]黄燕明,王燕,侯洁,等.重度原发性甲状腺功能减退并复发性双侧巨大卵巢囊肿1例[J].实用妇产科杂志,2017,33(3):236-237.
[6]付淑娟,周张杰,夏晓婷,等.直肠癌术后合并甲状腺机能减退治疗后致腹腔积液一例[J].实用肿瘤杂志,2017,32(6):555-556.
[7]黎洪展.甲状腺功能减退症主要表现体腔积液1例[J].第一军医大学分校学报,2003,26(1):80.