肝脏孤立性纤维性肿瘤及高分化直肠腺癌1例

S. Shinkarev, M. N. Lando, V. N. Brykin, R. V. Zhinkin, O. E. Pestryakov, D. A. Odegov
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摘要

孤立性纤维性肿瘤(SFT)是一种罕见的梭形细胞间充质肿瘤,可能起源于纤维母细胞,恶性潜能不明确,很少转移。他们最常见的定位是胸膜,在那里他们被首次描述。孤立性纤维性肿瘤局限于肝脏的发生率极低。SFT的临床表现是非特异性的,与肿瘤的解剖位置和大小无关。在大多数情况下,这些肿瘤是良性的。然而,他们中的一些人仍然可能有恶性肿瘤的迹象:一个侵略性的过程,可能局部复发和远处转移。具有可切除性的肝孤立性纤维性肿瘤(以及其他部位的SFT)的主要治疗方法是手术。在大多数病例中,根治肿瘤可以恢复。术后患者应像恶性肿瘤(MN)一样,严格进行有规律的动态观察。化疗和放疗在肝孤立性纤维性肿瘤治疗中的重要性至今尚未在临床指南中确定。当肿瘤切除不彻底或有恶性肿瘤迹象时,有使用化疗或放疗治疗的孤立报道。在文献中,有许多关于任何部位的孤立性纤维性肿瘤与同一患者其他器官恶性肿瘤合并的报道。在此报告中,我们报告了一位64岁女性的临床病例,她患有肝脏孤立的纤维性肿瘤和高分化的直肠腺癌。患者接受了肝左叶第一段切除术。一个半月后,经肛门切除直肠绒毛状肿瘤。肝肿瘤病理及免疫组化检查显示为恶性孤立性纤维性肿瘤。经研究直肠绒毛瘤——一种侵袭肠壁粘膜下层深度达1/3的高分化腺癌(据菊池称为T1sm1)。在术后25个月的动态观察中,患者无肿瘤复发和转移迹象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A rare case of solitary fibrous tumor of the liver and highly differentiated rectal adenocarcinoma
Solitary fibrous tumors (SFT) are rare spindle cell mesenchymal neoplasms of presumably fibroblastic origin with undefined malignancy potential and rare metastasis. Their most frequent localization is in the pleura, where they have been first described. The incidence of solitary fibrous tumors localized in liver is extremely low. The clinical picture of SFT is nonspecific and is not due to the anatomical location of the tumor and it's size.In the majority of cases these tumors are benign. However, a number of them still may have signs of malignancy: an aggressive course with possible local recurrence and distant metastasis. The main method of treatment of hepatic solitary fibrous tumor (as well as SFT of other localization) with it's resectability is surgery. Radical removal of the tumor in the majority of cases leads to recovery. Subsequently, the operated patients should be subjected to strict dynamic observation with regularity as in malignant neoplasms (MN).The importance for chemotherapy and radiation therapy in the treatment of hepatic solitary fibrous tumor has not been determined in clinical guidelines to date.There are isolated reports of the use of chemotherapy or radiation therapy for the treatment of cases when tumor resection is not radical or there are signs of malignant neoplasm.In literature, there are numerous reports of a combination of a solitary fibrous tumor of any localization with malignant neoplasms of other organs in the same patients.In this report, we represent a clinical case of a 64-year-old woman, who had a solitary fibrous tumor of the liver and highly differentiated rectal adenocarcinoma. The patient underwent resection of the first segment of the left lobe of the liver. After a month and a half, transanal excision of the villous tumor of the rectum. The pathologic and immunohistochemical examination of the liver tumor revealed a malignant solitary fibrous tumor. After researching villous tumor of the rectum - a highly differentiated adenocarcinoma with a depth of invasion of the submucous layer of the intestinal wall up to 1/3 (T1sm1 according to Kikuchi). During dynamic observation for twenty-five months after the operation, the patient has no signs of tumor recurrence and metastasis.
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