Jha Swati, Chan K K, Poole Christopher J, Rollason T P
Worcester Royal Hospital, Worcester, UK.
Gynecol Oncol. 2005 Jun;97(3):935-7. doi: 10.1016/j.ygyno.2005.02.027. Epub 2005 Apr 15.
Ovarian angiosarcomas are rare tumors which may to be distinguished from other unusual primary ovarian tumors such as clear cell carcinoma, yolk sac tumor and leiomyosarcoma on the basis of histological appearance and immunohistochemistry. Angiosarcomas of the ovary occur in all age groups but are more frequent in women of child bearing age (less than 40 years). Surgery and radiotherapy have been the traditional treatment modalities.
The case we present is the only reported long-term survivor of recurrent ovarian angiosarcoma. Her initial treatment was surgical, both at presentation and relapse but since she wished conservation of fertility, radical surgery and radiotherapy were avoided and she underwent further adjuvant chemotherapy with doxorubicin and ifosfamide. She remains in remission 6 years after treatment of recurrence of the primary tumor and has had a successful pregnancy following treatment.
Adjuvant chemotherapy of ovarian angiosarcoma with a combination of doxorubicin and ifosfamide appears effective and should be considered in women at risk of relapse who wish to conserve fertility.
卵巢血管肉瘤是罕见肿瘤，可根据组织学表现和免疫组化与其他不常见的原发性卵巢肿瘤如透明细胞癌、卵黄囊瘤和平滑肌肉瘤相鉴别。卵巢血管肉瘤可见于所有年龄组，但在育龄妇女（小于40岁）中更为常见。手术和放疗一直是传统的治疗方式。
我们所呈现的该病例是复发性卵巢血管肉瘤唯一报道的长期存活者。她初次就诊及复发时的初始治疗均为手术，但由于她希望保留生育功能，避免了根治性手术和放疗，而是接受了阿霉素和异环磷酰胺的进一步辅助化疗。在原发性肿瘤复发治疗6年后她仍处于缓解期，且治疗后成功妊娠。
阿霉素和异环磷酰胺联合辅助化疗对卵巢血管肉瘤似乎有效，对于有复发风险且希望保留生育功能的女性应予以考虑。
