患者67岁,孕_1产_0。因腹胀1月余入院。既往月经正常,无痛经。17年前绝经,从未有不规则阴道流血、溢液、腹痛。近月来食欲下降,体重减轻。27年前因“宫外孕”手术。入院体查:一般情况差,全身浅表淋巴结未扪及肿大,心肺阴性。腹蛙形,腹围86厘米,下腹正中可见10厘米疤痕。腹软,未扪及包块。无压痛,肌紧张及反跳痛,肝脾未扪及肿大。移动性浊音阳性。妇科检查:外阴及阴道无异常;宫颈萎缩,无充血,质硬,活动差;后穹窿触之结节感。子宫扪诊不满意.右侧附件可扪及15×14厘米实质性包块,形状不规则,表面凸凹不平,上界 The patient was 67 years old, and her pregnacy was _1. Due to abdominal distension for more than one month admitted to the hospital. Normal menstruation before, no pain. 17 years ago menopause, no irregular vaginal bleeding, discharge, abdominal pain. In recent months, appetite has decreased and weight has decreased. 27 years ago because of “ectopic pregnancy” surgery. Admission examination: The general situation is poor, the whole body has no lymph node enlargement, and the heart and lungs are negative. Abdominal frog shaped, abdominal circumference 86 centimeters, 10 centimeters scar visible in the lower abdomen. Soft abdomen, no palpable mass. No tenderness, muscle tension and rebound tenderness, hepatospleno and splenomegaly. Positive shifting dullness. Gynecological examination: no abnormalities of the vulva and vagina; cervical atrophy, no congestion, hard quality, poor activity; posterior malleolus touch the nodules. Uterine percussion dissatisfaction. Right annex can be palpable and 15 × 14 cm substantial mass, irregular shape, uneven surface, upper bound