Zenico Teo, Saccomanni Mauro, Salomone Umberto, Bercovich Eduard
Department of Urology, Morgagni-Pierantoni Hospital, Forlì, Italy.
Tumori. 2011 Jul-Aug;97(4):e6-9. doi: 10.1177/030089161109700422.
This article focuses on a rare case of primary renal angiosarcoma in a 56-year-old man with a previous clinical history of stage III Hodgkin's lymphoma treated with supra- and subdiaphragmatic radiotherapy, splenectomy in association with vincristine-based chemotherapy and thermochemotherapy, and subsequent thymectomy. The patient was referred to the department of urology from the department of cardiology, where he had been seen for right coronary stenosis after the incidental finding on an abdominal scan of a large left renal mass. There was no family history of renal cancer. Diagnosis was high-grade angiosarcoma, extensively necrotic and hemorrhagic, involving the renal parenchyma and perirenal soft tissue. Taking into account tumor histology, grade, size and site as well as patient's age and general condition, a therapeutic program was planned comprising surgery followed by chemotherapy (epirubicin 60 mg/m² and ifosfamide 3000 mg/m²). Adjuvant radiotherapy, normally delivered to the site of surgery, was not considered necessary. Unfortunately the patient died 4 months after surgery, before chemotherapy was started. Our paper highlights the extreme rarity and aggressiveness of renal sarcoma, its poor prognosis, and the fact that there is no one, accepted approach to its treatment.
本文聚焦于一名56岁男性原发性肾血管肉瘤的罕见病例,该患者既往有III期霍奇金淋巴瘤临床病史,接受过膈上和膈下放疗、联合长春新碱化疗及热化疗的脾切除术,随后进行了胸腺切除术。患者因腹部扫描偶然发现左肾巨大肿块后出现右冠状动脉狭窄,从心内科转诊至泌尿外科。患者无肾癌家族史。诊断为高级别血管肉瘤,广泛坏死和出血,累及肾实质和肾周软组织。综合考虑肿瘤组织学、分级、大小、部位以及患者年龄和一般状况,制定了一个治疗方案,包括手术,随后进行化疗(表柔比星60 mg/m²和异环磷酰胺3000 mg/m²)。通常在手术部位进行的辅助放疗未被认为有必要。不幸的是,患者在手术后4个月死亡,尚未开始化疗。我们的论文强调了肾肉瘤极其罕见和侵袭性强、预后不良,以及目前尚无公认的治疗方法这一事实。