Takezawa Kentaro, Kakimoto Kenichi, Yoshida Takahiro, Arai Yasuyuki, Ono Yutaka, Meguro Norio, Usami Michiyuki
The Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Hinyokika Kiyo. 2009 Nov;55(11):691-4.
The patient, a 55-year-old man, had undergone surgery for retroperitoneal paraganglioma at the age of 45. In February 2006, he visited our hospital with the chief complaint of metastatic tumors detected by a thorough checkup. Computed tomographic (CT) scan revealed a large tumor in the right kidney hilar region and a left supraclavicular lymphadenopathy. Histopathological and immunohistochemical findings of the biopsy specimen taken from the left supraclavicular lymph node led to the diagnosis of recurrent malignant paraganglioma. 123I-MIBG scintigram showed no radioisotope accumulation consistent with the tumor. From April 2006 to September 2006, he received 8 cycles of CVD therapy (cyclophosphamide, vincristine, and dacarbazine). The tumor temporarily responded and was reduced to one-third in size, but soon it became resistant to CVD therapy. In March 2007, because the tumor had begun to grow, he received the 9th course of CVD therapy, but the tumor response was PD. Subsequently, palliative radiation therapy of 50 Gy in 25 fractions was administered and was temporarily effective. The CVD therapy and radiation therapy were considered to be effective for this case. In May 2008, he died 25 months after the start of CVD therapy.
患者为一名55岁男性，45岁时接受了腹膜后副神经节瘤手术。2006年2月，他因全面体检发现转移性肿瘤为主诉前来我院就诊。计算机断层扫描（CT）显示右肾门区有一个大肿瘤和左侧锁骨上淋巴结肿大。从左侧锁骨上淋巴结获取的活检标本的组织病理学和免疫组织化学检查结果确诊为复发性恶性副神经节瘤。123I-MIBG闪烁扫描显示肿瘤部位无放射性同位素聚集。2006年4月至2006年9月，他接受了8个周期的CVD治疗（环磷酰胺、长春新碱和达卡巴嗪）。肿瘤暂时有反应，大小缩小至原来的三分之一，但很快对CVD治疗产生耐药性。2007年3月，由于肿瘤开始生长，他接受了第9个疗程的心CVD治疗，但肿瘤反应为疾病进展（PD）。随后，给予了25次分割、总剂量为剂量为50 Gy的姑息性放疗，且暂时有效。CVD治疗和放疗被认为对该病例有效。2008年5月，他在开始CVD治疗25个月后死亡。
