Kaku M, Ohara N, Seima Y, Imanishi K, Tomura N, Kobayashi A, Yamasaki M, Hirata Y, Murao S
Department of Internal Medicine, Kaku Clinic, Kobe, Japan.
Arch Gynecol Obstet. 2004 Dec;270(4):302-6. doi: 10.1007/s00404-003-0550-5. Epub 2003 Oct 10.
We describe a 44-year-old woman with a primary retroperitoneal serous cystadenocarcinoma as the fourth report in the world literature. A contrast-enhanced computed tomographic scan of the abdomen demonstrated a mass with enhanced solid mural nodules and septa in the left retroperitoneum. Serum CA19-9 was elevated at 181 U/ml. The patient underwent a complete resection of the retroperitoneal tumor with a partial resection of the psoas major muscle and its fascia. Pathological examination showed a well-differentiated papillary serous cystadenocarcinoma of ovarian type and locoregional lymph node metastases. Seven months after surgery, the patient developed a pelvic recurrence, and underwent a total hysterectomy, a left salpingo-oophorectomy and a resection of the metastatic mesenteric mass. Two months after the second surgery, serum CA19-9 and CA125 increased to 1,114 U/ml and 218 U/ml, respectively. A solitary liver metastasis was confirmed on a computed tomographic scan. The patient is now being treated with weekly docetaxel and carboplatin.
The present case illustrates the clinically aggressive nature of a primary retroperitoneal serous cystadenocarcinoma.
我们报道了一名44岁的女性原发性腹膜后浆液性囊腺癌患者，这是世界文献中的第四例报告。腹部增强计算机断层扫描显示左腹膜后有一个伴有强化实性壁结节和分隔的肿块。血清CA19-9升高至181 U/ml。患者接受了腹膜后肿瘤的完整切除，并部分切除了腰大肌及其筋膜。病理检查显示为卵巢型高分化乳头状浆液性囊腺癌并伴有局部区域淋巴结转移。术后七个月，患者出现盆腔复发，接受了全子宫切除术、左侧输卵管卵巢切除术和转移性肠系膜肿块切除术。第二次手术后两个月，血清CA19-9和CA125分别升至1114 U/ml和218 U/ml。计算机断层扫描证实有一个孤立性肝转移。患者目前正在接受每周一次的多西他赛和卡铂治疗。
本病例说明了原发性腹膜后浆液性囊腺癌的临床侵袭性。
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