摘要
慈濟醫院婦產科自民國78年10月至80年5月間，共有68例附屬器腫瘤患者接受手術評估與治療。年紀最輕的病患是12歲，最者的病患是77歲；其中85.2%的病患是介於21歲至50歲之間。下腹部疼痛是最常見之臨床症狀，佔70.6%；68例患者中有8例完全無任何徵狀，只因例行子宮頸抹片檢查或剖腹生產時意外發現。分析患者之病理組織檢查結果以子宮內膜異位瘤(endometrioma)最常見，佔19.1%；其次是卵巢皮樣囊腫(dermoid cyst)及卵巢水瘤(ovarian simple cyst)，各佔17.1%。其中有五例惡性腫瘤，佔7.4%；病理組織分別是2例不成熟型畸胎瘤，1例卵黃瘤，1例Krukenberg腫瘤，1例小腸肌肉瘤。探討腫瘤大小與病理組織之間的關係，結果直徑小於6公分或大於20公分以上之腫瘤並無惡性病例，而腫瘤直徑在10至19公分之間的有21.4%(3/14)，在6至9公分之間的有5.7%(2/35)是惡性病例。本研究就患者之臨床資料及手術病理報告加以分析，希望對附屬器惡性瘤之診斷有所助益。
關鍵字
附屬器腫瘤並列摘要
The patients with a “adnexal mass” are a challenge to the gynecologist. The clinician must weigh the risk of operating on a woman with a functional ovarian cyst against delaying surgery on a women with malignancy. The study was done in an attempt to determine the frequency of malignancy in these lesions to set guidelines for appropriate evaluation and treatment. Between October 1, 1989 and May 31, 1991, we reviewed 68 patients who underwent laparotomy and/or laparoscopy with the dignosis of adnexal mass/cyst. The 68 women with adnexal mass in the present study had an overall incidence of malignancy of 7.4%. The risk increased after 50 years to 16.7%. Of the 68 patients evaluated for adnexal mass, the finding were: endometriosis, 13 (19.1%); dermoid cyst, 12(17.6%); benign ovarian cyst, 12 (17.6%); mucinous cystadenoma 6 (8.8%); tubo-ovarian abscess, 6 (8.8%); hydrosalpinx, 5 (7.4%); cancer, 5 (7.4%); others, 4 (5.9%). Thirty-five patients (51.5%) in this study group had size between 6 to 9 cm in diameter. None of 19 masses smaller than 6 cm or larger than 20 cm in diameter was malignant. Of 35 masses 6-9 cm in diameter, 2 were malignant. Of 14 tumors 10-19 cm in diameter, 3 were malignant. This study provided data on which clinicians can be diagnostic probability for various adnexal masses. Early diagnosis of malignant tumors is crucial to optimal treatment results.