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1病历摘要患者,14岁,因不规则阴道流血10+月于2016年12月22日在我院就诊。患者2016年3月出现阴道不规则流血,量时多时少,淋漓不尽。2016年6月至当地医院查体,未发现明显异常,予中药等对症治疗。后因阴道血性分泌物并伴异味再次至当地医院检查,2016年11月在当地医院行腹部B超检查,提示:宫颈阴道部占位。12月9日外院盆腔MRI平扫显示肿块呈外生型,蒂位于宫颈前唇,向下突入阴道,T1WI等信号,T2WI呈高亮信号(见图1),宫颈管无明显狭窄,子宫内膜无增厚。盆腔未见明显肿大淋巴结。遂行“宫腔镜下阴道上段肿块电切术”。据手术记录,术中见:阴道内约4 cm大小实性肿块,组织糟脆,部分呈水泡状,血供丰富,肿物蒂部位于宫颈,蒂部较宽。患者术后于12月20日复查盆腔MRI提示肿块大部分被切除,宫颈前唇仍有软组织信号,疑有残留(见图2)。
1 patient summary of patients, 14 years old, due to irregular vaginal bleeding 10 + month in December 22, 2016 in our hospital. Patients with vaginal irregular bloodshed in March 2016, the amount of time less, dripping endless. In 2016 June to the local hospital examination, no significant abnormalities, such as symptomatic treatment of traditional Chinese medicine. After due to vaginal discharge and accompanied by bad smell to the local hospital again in November 2016 in the local hospital abdomen B-ultrasound, tips: Cervix vaginal Department. On December 9, pelvic MRI showed that the tumor was exophytic. The pedicle was located in the anterior cervical lip and protruded downward into the vagina, T1WI and other signals. The T2WI showed a bright signal (see Figure 1). The cervical canal had no obvious stenosis and the uterus No thickening of the membrane. No significant enlarged pelvic lymph nodes. Carry out “hysteroscopic vaginal mass resection surgery ”. According to the surgical records, intraoperative see: the vagina about 4 cm in size solid mass, tissue crisp, some were blisters, rich in blood supply, pedunculated pedicle in the cervix, pedicle wide. Patients after review on December 20 pelvic MRI showed that most of the tumor was removed, there is still a soft tissue signal in the anterior cervical lip, suspected residual (see Figure 2).