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[一例经异环磷酰胺和顺铂成功治疗的腹膜后去分化脂肪肉瘤]

[A case of retroperitoneal dedifferentiated liposarcoma successfully treated with IFM and CDDP].

作者信息

Yokoi Miki, Hosokawa Kenzo, Funaki Hiroshi, Yoshitani Shinichiro, Kinami Shinichi, Omote Kazuhiko, Ueda Nobuhiko, Nakano Yasuharu, Kosaka Takeo, Minato Hiroshi

机构信息

Department of Surgical Oncology, Kanazawa Medical University.

出版信息

Gan To Kagaku Ryoho. 2009 Nov;36(12):2114-6.

Abstract

A 53-year-old man was evaluated for a chief complaint of abdominal bloating. Physical examination revealed an abdominal distention and ascites, and CT showed multiple large retroperitoneal masses. The patient was diagnosed with retroperitoneal liposarcoma. Surgery was performed including the tumor, small bowel, and sigmoid resection, and an artificial anus was constructed. Multiple tumors in the peritoneum were noted. Large dark red tumors that were hemorrhagic were resected, but the yellowish tumors were unresectable. On histopathology, the dark red lesions showed dedifferentiated liposarcoma, and the yellowish lesions showed well-differentiated liposarcoma. One month postoperatively, peritoneal dissemination increased including nodular infiltration of the artificial anus and multiple hepatic metastases. Despite VAC chemotherapy (VCR 1.5 mg, ACD 0.5 mg, CPA 900 mg), progressive disease (PD) was noted. As second-line chemotherapy, weekly IFM (2 g)+CDDP (30 mg) was given. Shrinkage of the tumor infiltrates in the artificial anus, decreased abdominal bloating, and improved QOL were observed. A partial response (PR) against peritoneal dissemination was achieved. However, hepatic metastases increased, and the patient died 6 months after surgery. This case suggests that IFM+CDDP may be useful in dedifferentiated liposarcoma.

摘要

一名53岁男性因腹胀为主诉前来就诊。体格检查发现腹部膨隆及腹水,CT显示多个巨大腹膜后肿块。患者被诊断为腹膜后脂肪肉瘤。进行了包括肿瘤、小肠和乙状结肠切除的手术,并造了人工肛门。术中发现腹膜内有多个肿瘤。切除了暗红色的出血性大肿瘤,但淡黄色肿瘤无法切除。组织病理学检查显示,暗红色病变为去分化脂肪肉瘤,淡黄色病变为高分化脂肪肉瘤。术后1个月,腹膜播散增加,包括人工肛门结节状浸润及多发肝转移。尽管进行了VAC化疗(长春新碱1.5mg、放线菌素D 0.5mg、环磷酰胺900mg),仍出现疾病进展(PD)。作为二线化疗,给予每周一次的异环磷酰胺(2g)+顺铂(30mg)。观察到人工肛门处肿瘤浸润缩小、腹胀减轻及生活质量改善。对腹膜播散取得了部分缓解(PR)。然而,肝转移增加,患者术后6个月死亡。该病例提示异环磷酰胺+顺铂可能对去分化脂肪肉瘤有效。

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