40.一位34歲女性,G0(gravida),已嘗試懷孕3年都未能成功受孕。她有多年骨盆腔疼痛及嚴 重的性交疼痛(dyspareunia)。骨盆腔檢查發現nodular and tender uterosacral ligament, 子宮後傾(retroverted)但大小正常,以及右側附屬物腫塊。陰道超音波發現一個6公分的右 側卵巢腫瘤。抽血檢查方面,CA 125指數上升。接下來最適當的處置為下列何者﹖
(A)促性腺激素釋放荷爾蒙類似體(GnRH agonist)
(B)診斷性腹腔鏡手術(diagnostic laparoscopy)
(C)腹腔鏡卵巢囊腫切除術(laparoscopy with cystectomy)
(D)腹腔鏡右側卵巢切除術(laparoscopy and right oophorectomy)

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統計: A(3), B(31), C(30), D(13), E(0) #1043600

詳解 (共 3 筆)

#2689769
●Oophorectomy rather...
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#3104138

Ovarian endometriomas are common and are regarded as specific manifestation of the disease endometriosis. Laparoscopic cystectomy is the gold standard surgical technique of clinical care for women with endometriosis and pelvic pain or infertility. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150139/

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#6109174

症狀描述像是子宮內膜異位症跑到卵巢變巧克力囊腫,診斷的黃金準則是腹腔鏡切片,但這題還沒排除惡性卵巢腫瘤,從選項C給cystectomy看起來只能答C了

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