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经诊断影像学和尸检证实的原发性子宫颈神经内分泌肿瘤伴脑膜癌病 1 例。

A case of primary uterine cervical neuroendocrine tumor with meningeal carcinomatosis confirmed by diagnostic imaging and autopsy.

机构信息

Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan.

出版信息

Int J Clin Oncol. 2011 Oct;16(5):581-6. doi: 10.1007/s10147-010-0155-5. Epub 2010 Dec 15.

Abstract

Primary uterine cervical neuroendocrine tumors are rare, but affect relatively young women and the prognosis is poor despite multidisciplinary treatment. The incidence of meningeal carcinomatosis arising from malignant tumors of the uterine cervix is extremely low, only two patients with meningeal carcinomatosis arising from a uterine cervical neuroendocrine tumor have been reported in the English literature. Moreover, there have been no reports in which this was confirmed at autopsy. We encountered a pregnant woman aged 33 years who was diagnosed as having atypical carcinoid of the uterine cervix after radical surgery. Despite multidrug chemotherapy (paclitaxel + etoposide + cisplatin and irinotecan + carboplatin), the patient developed multiple organ metastases. Although there was no metastasis to the brain parenchyma or the spinal cord parenchyma, the patient also developed meningeal carcinomatosis. Whole-brain radiation therapy was performed, but was ineffective. The patient died at 19 months after her initial operation and 10 days after diagnosis of meningeal carcinomatosis. The presence of meningeal carcinomatosis was confirmed at autopsy.

摘要

原发性子宫颈神经内分泌肿瘤较为罕见,但好发于相对年轻的女性,尽管采用多学科治疗,预后仍较差。源于宫颈恶性肿瘤的脑膜癌病发病率极低,英文文献中仅报道过 2 例源于宫颈神经内分泌肿瘤的脑膜癌病。此外,尚无尸检证实的报道。我们遇到了 1 例 33 岁的孕妇,根治术后诊断为子宫颈不典型类癌。尽管采用多药化疗(紫杉醇+依托泊苷+顺铂和伊立替康+卡铂),患者仍发生了多器官转移。尽管脑实质或脊髓实质无转移,但患者也发生了脑膜癌病。行全脑放疗,但无效。患者在初始手术 19 个月后和诊断脑膜癌病 10 天后死亡。尸检证实存在脑膜癌病。

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