患者女,49岁。该患于1977年发现外阴有一包块,初为黄豆大,3年后长至鸡蛋大,在当地医院行局部手术切除(未送病理检查)。术后数月在原来位置又长一同样肿物,比第一次生长快。一年后检查:右侧小阴唇下(?)处有一鸡蛋大小包块,质硬,固定于皮下,局部皮肤粘膜无红肿及压痛,初步诊断外阴纤维瘤,于1981年9月29日行肿瘤剔除术。术中见瘤体呈灰白色,约4.5×4×3cm,与周围皮下组织稍有粘连,肿物无明显包膜,无蒂。术后创口一期愈合。肿物病理报告为:外阴颗粒性肌母细胞瘤(良性)。术后半年,局部又复发,至1982年9月长如鸡蛋大小。在省医院行外阴切除、鼠蹊淋巴结清扫及腹膜外淋巴结廓清术。病理报告为外阴颗粒性肌母细胞瘤,右鼠蹊淋巴结转移。1983年4月,患者外阴部又发现一蚕豆大小肿物,并于患者右上腹部触及一包块,再次入院。检查:右上腹包块约8×6cm,质硬,随呼吸运动,与肝脏相连,边界尚光滑,无压痛。超声波探查见右上腹包块呈实质性反射,与肝脏相连。诊断:外 Female patient, 49 years old. The patient found in 1977, there is a mass of the genital mass, initially soybeans, 3 years after the egg grow to large, the local hospital line local surgical removal (not sent pathological examination). After a few months in the original location and a long same tumor, faster than the first growth. A year later check: the right side of the labia minora (?) At an egg-sized mass, hard, fixed in the skin, local skin and mucous membrane without swelling and tenderness, the initial diagnosis of vulvar fibroids, on September 29, 1981 tumor Excision surgery. Surgery, see the tumor was gray, about 4.5 × 4 × 3cm, with a slight adhesions around the subcutaneous tissue, the tumor no significant capsule, no pedicle. Postoperative wound healing. Tumor pathology report: Vulvar granular myoblastoma (benign). Six months after surgery, local recurrence, as long as September 1982, such as egg size. In the provincial hospital line vulvectomy, groin lymph node dissection and extraperitoneal lymph node dissection. Pathology report for the vulvar granular myoblastoma, right foot lymph node metastasis. April 1983, the patient found a mass of the genitals in the vulva and mass in the right upper quadrant of the patient touched a mass, again hospitalized. Check: The right upper quadrant mass about 8 × 6cm, hard, with respiratory movement, connected with the liver, the border is still smooth, no tenderness. Ultrasound exploration see the right upper quadrant showed substantial reflex, and the liver connected. Diagnosis: outside