[腹膜后癌肉瘤1例报告]

Yu Ito, Kohei Hashimoto, Tetsuya Shindo, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori
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引用次数: 0

摘要

我们报告一例腹膜后癌肉瘤。一位48岁女性,左侧腹痛,CT显示左下肾腹膜后区有一个15厘米的肿瘤。增强CT显示一清晰的肿瘤,在腹膜后有造影剂效果。磁共振成像(MRI)在t2加权图像上显示非均匀囊性肿块和增强良好的肿瘤壁结节。她的血清CA-125和CA-19-9水平分别为44.7和143.0 U/mL。虽然她被诊断为原发性腹膜后粘液囊腺癌并接受手术切除,但病理诊断为腹膜后癌肉瘤。未给予辅助治疗。2个月CT表现为局部复发及多发肺转移。每3周给予紫杉醇(第1天175 mg/m2)和卡铂(第1天6曲线下面积)(TC)治疗。经2个疗程TC治疗后,部分肺转移灶消失缩小,但观察到局部复发进展。然而,经过7个疗程的TC治疗后,局部复发进一步进展,并伴有腹壁浸润和腰痛,确定为进行性疾病(PD)。全面的基因组分析测试显示没有可操作的基因突变。她在癌症复发5个月后死于癌症。癌肉瘤是一种罕见的肿瘤,预后较差,除手术切除外尚无确定的治疗方法。在这种情况下,治疗剂无法确定;然而,基因组分析应该用于指导晚期癌肉瘤的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A CASE OF CARCINOSARCOMA OF THE RETROPERITONEUM: A CASE REPORT].

We present a case of retroperitoneal carcinosarcoma. A 48-year-old woman with left-sided abdominal pain and a 15 cm tumor in the lower left renal retroperitoneal region on computed tomography (CT) was referred to our hospital. Contrast-enhanced CT showed a well-defined tumor with contrast effect on the retroperitoneum. Magnetic resonance imaging (MRI) demonstrated a heterogeneous cystic mass and well-enhanced mural nodules in the tumor on T2-weighted images. Her levels of serum CA-125 and CA-19-9 were high at 44.7 and 143.0 U/mL, respectively. Although she was diagnosed with primary retroperitoneal mucinous cystadenocarcinoma and underwent surgical resection, the pathological diagnosis was a carcinosarcoma on the retroperitoneum. No adjuvant therapy was given. CT findings at 2 months revealed local recurrence and multiple pulmonary metastases. She received paclitaxel (175 mg/m2 on day 1) and carboplatin (area under the curve of 6 on day 1) (TC) every 3 weeks. After two courses of TC therapy, some pulmonary metastases disappeared and shrank, but the progression of local recurrence was observed. However, after seven total courses of TC therapy, local recurrence further progressed, with the infiltration of the abdominal wall and lumbar pain, which was determined to be progressive disease (PD). A comprehensive genomic profiling test revealed no actionable genetic mutations. She died of cancer five months after the disease recurred. Carcinosarcoma is a rare tumor with poor prognosis, for which no established treatment exists beyond surgical resection. In this case, the therapeutic agent could not be determined; however, genomic analysis should be performed to guide the treatment of carcinosarcoma in advanced cases.

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