Kunieda K, Saji S, Kuwabara I, Watanabe A, Katoh M, Sugiyama Y, Shimokawa K
Second Department of Surgery, Gifu University School of Medicine, Gifu-city, Japan.
Surg Today. 2000;30(4):372-5. doi: 10.1007/s005950050603.
We report herein the case of a 69-year-old man in whom rapid growth of a retroperitoneal rhabdomyosarcoma occurred following hemicolectomy for ascending colon cancer. On his first admission for surgery, a small lesion, 1.5 cm in diameter, was detected adjacent to the inner side of the left kidney by abdominal axial computed tomography (CT), which was initially suspected to be a benign lesion; however, a postoperative follow-up CT scan done 5 months later revealed that the lesion had enlarged remarkably to 8 cm in diameter. Thus, total resection was performed under the presumed diagnosis of a malignant retroperitoneal tumor. The tumor was found to be adjacent to the inner portion of the left kidney and covered by Gerota's fascia. As it involved the ileolumbar muscle and had a metastatic lymph node, complete resection was performed. The resected specimen was 8.5 x 6.5 x 5 cm in size and was histologically confirmed as a retroperitoneal rhabdomyosarcoma of embryonal type. Two courses of adjuvant chemotherapy with adriamycin, vincristine, and cyclophosphamide were given, and the patient has shown no signs of recurrence for 2 years since his second operation.
我们在此报告一例69岁男性患者，其在因升结肠癌行半结肠切除术后，腹膜后横纹肌肉瘤迅速生长。在他首次入院接受手术时，腹部轴向计算机断层扫描（CT）在左肾内侧附近检测到一个直径1.5厘米的小病变，最初怀疑是良性病变；然而，5个月后进行的术后随访CT扫描显示，该病变已显著增大至直径8厘米。因此，在假定为恶性腹膜后肿瘤的诊断下进行了全切除。发现肿瘤与左肾内侧部分相邻，并被肾周筋膜覆盖。由于它累及髂腰肌肉且有一个转移性淋巴结，故进行了完整切除。切除标本大小为8.5×6.5×5厘米，组织学确诊为胚胎型腹膜后横纹肌肉瘤。给予了两个疗程的阿霉素、长春新碱和环磷酰胺辅助化疗，自第二次手术后该患者已2年无复发迹象。
