患者朱××,34岁,妊娠足月合并卵巢未成熟畸胎瘤扭转,于外院行剖宫产术、次全子宫及双附件切除术,手术中见右侧腹壁有转移瘤,未能切除。术后一个月即1986年1月27日在我院经腹正中切口剖腹探查,术中见肿瘤位于右下腹腹直肌内约12×10×10cm~3,无包膜,盲肠壁有数处转移灶。切除腹直肌内肿瘤大部,创腔内止血后放入5—Fu1500mg。盲肠病灶未予处理。术后发热,于术后22天右下腹壁红肿破溃,切开后见原肿瘤创腔内有脓汁及粪便样物800ml,盲肠上有1cm瘘孔。以胶管引流创腔,术后38天突然自创腔内流出新鲜血液1800ml,继而休克死亡。死后检查创腔左侧壁一动脉破裂,创腔内壁布满肿瘤组织。病例讨论花宜庆医师:妊娠合并盆腔包块,一旦确定为卵巢肿瘤,就应尽早区分是良或恶性,对确定下一步治疗有决定性意义。详询病史,全面检查是判定良、恶性不能缺少的步骤。通常孕期血运丰富,肿瘤增长加速,有的出现腹水、恶病质。盆腔检查:恶性瘤实性居多,也有囊实相间者,常合并腹水,多和周围脏器粘连。辅助检查腹水查到癌细胞可确诊;B型超声检查早期诊断卵巢癌有帮助,且对孕妇及胎儿无害可反复 Patients Zhu × ×, 34 years old, full-term pregnancy combined with immature ovarian teratoma torsion, in the hospital line cesarean section, subtotal uterine and double attachment resection, the surgery see the right abdominal wall metastases, failed to remove . One month after surgery in January 27, 1986 in our hospital through the median abdominal incision laparotomy, the surgery see the tumor located in the right lower quadrant of the rectus abdominis muscle about 12 × 10 × 10cm ~ 3, no capsule, several changes in the cecum wall kitchen. Resection of most of the rectus abdominis tumor, intracranial hemostasis into the 5-Fu1500mg. Cecal lesions not treated. Postoperative fever, 22 days after the right lower abdominal wall swelling and ulceration, incision see the original tumor cavity with pus and stool samples 800ml, 1cm fistula on the caecum. Drainage with a plastic drainage chamber, 38 days after the sudden self-created cavity outflow of fresh blood 1800ml, followed by shock death. Check after death on the left side of the wall of an artery rupture, wound cavity covered with tumor tissue. Case discussion Hua Yiqing physician: pelvic mass pregnancy complicated, once identified as ovarian cancer, it should be as early as possible to distinguish between good or malignant, to determine the next step treatment of decisive significance. Detailed history, a comprehensive examination is to determine the good and malignant can not be missing steps. Usually rich in blood during pregnancy, tumor growth accelerated, and some ascites, cachexia. Pelvic examination: Malignant tumor solid majority, but also between the capsule and the solid, often with ascites, and more adhesions around the organs. Auxiliary examination of ascites found that cancer cells can be diagnosed; B-type ultrasound early diagnosis of ovarian cancer is helpful and harmless to pregnant women and fetus can be repeated