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患者女性,60岁,因腹部包块一月余,绝经10年后阴道流血半天来院就诊。22岁结婚,未生育。体检:下腹中部偏右侧可触及肿块,光滑,约6×6cm大小,有压痛。妇科检查:外阴未产式,阴道光,内有中量暗红色血液。宫颈光滑,血自宫颈口流出;宫体中位,增大如孕3个月,质硬不规则,活动差,有压痛。右侧附件成一6×4×4cm肿块,与子宫分界不清,质硬不规则,有压痛;左侧附件在子宫后方形成一6×6×4cm大小肿块,实质性,稍软,不活动,无压痛。拟诊子宫肌瘤合并宫体腺癌,双侧卵巢肿瘤,作全子宫及双侧附件切除。
Female patient, 60 years old, due to abdominal mass more than a month, 10 years after menopause, vaginal bleeding for a long time to the hospital. 22-year-old married, not childbearing. Physical examination: the lower right middle abdomen palpable mass, smooth, about 6 × 6cm size, tenderness. Gynecological examination: Unproductive genital, vaginal light, dark red blood in the amount. Cervical smooth, blood flow out of the cervix; median palace, increased, such as pregnancy 3 months, hard and irregular, poor activity, tenderness. The right attachment into a 6 × 4 × 4cm mass, clear boundaries with the uterus, hard and irregular, tenderness; left attachment in the rear of the uterus to form a 6 × 6 × 4cm size lumps, substantive, slightly soft, inactive, No tenderness. The proposed diagnosis of uterine fibroids with adenocarcinoma of the uterus, bilateral ovarian tumors for the whole uterus and bilateral attachment resection.