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复发性宫颈癌罕见转移至心包和腹部肌肉。

Rare metastases of recurrent cervical cancer to the pericardium and abdominal muscle.

作者信息

Kim Hee Seung, Park Noh-Hyun, Kang Soon-Beom

机构信息

Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea.

出版信息

Arch Gynecol Obstet. 2008 Nov;278(5):479-82. doi: 10.1007/s00404-008-0602-y. Epub 2008 Feb 26.

Abstract

Pericardial metastasis from recurrent cervical cancer is very rare. There have been few case reports of such cases in which antemortem diagnoses were established. Cases of additional abdominal muscular metastasis have not been reported previously, although a small number of cases of additional skin metastasis have been reported. A 64-year-old woman with intermittent vaginal bleeding was referred under the clinical impression of cervical cancer. Further investigation revealed a cervical cancer (FIGO stage Ib), and she underwent a radical hysterectomy followed by adjuvant concurrent chemoradiation. During the post-operative follow-up period of 6 months, pericardial and abdominal muscular metastases were developed along with the symptoms of dry cough and dyspnea. We recommended a palliative pericardial window, but the patient rejected it. Although palliative radiation therapy and chemotherapy were performed for the control of the metastases, she expired due to cardiac failure 16 months after the operation. The prognosis of patients with pericardial and abdominal wall metastases from recurrent cervical cancer is usually poor because of the systemic dissemination of the disease. Aggressive local and systemic treatments may provide significant palliation of associated symptoms.

摘要

复发性宫颈癌的心包转移非常罕见。生前确诊的此类病例报告很少。虽然有少数额外皮肤转移的病例报告,但此前尚未有额外腹部肌肉转移的病例报告。一名64岁间歇性阴道出血的女性因宫颈癌的临床印象被转诊。进一步检查发现为宫颈癌(国际妇产科联盟分期Ib期),她接受了根治性子宫切除术,随后进行辅助同步放化疗。在术后6个月的随访期间,出现了心包和腹部肌肉转移,并伴有干咳和呼吸困难症状。我们建议进行姑息性心包开窗术,但患者拒绝了。尽管为控制转移进行了姑息性放疗和化疗,但她在术后16个月因心力衰竭死亡。复发性宫颈癌心包和腹壁转移患者的预后通常较差,因为疾病已发生全身播散。积极的局部和全身治疗可能会显著缓解相关症状。

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