Muntz H G, Goff B A, Fuller A F
Department of Gynecology, Massachusetts General Hospital, Boston.
Eur J Gynaecol Oncol. 1990;11(4):263-8.
We report a patient who, at age 43, underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for an unrupted 10 cm granulosa cell tumor. A recurrence was subtotally totally resected 2.5 years later, followed by six cycles of cyclophosphamide, doxorubicin, and cis-platin (CAP) chemotherapy. She had no evidence of disease at second-look laparotomy. Serum estradiol (E2) levels paralleled her clinical course, becoming elevated at the time of her recurrence, and returning to postmenopausal levels during her chemotherapy. Four years later, further elevation in E2 heralded a second recurrence of tumor. The patient underwent a cytoreductive procedure and has resumed chemotherapy. Reports of the few other patients treated with multiagent chemotherapy are reviewed. Several combinations appear active, with the CAP regimen having possibly less toxicity. Compared with radiotherapy, chemotherapy may yield longer survival in patients with recurrent granulosa cell tumor, but actual cure remains elusive.
我们报告了一名43岁的患者，其因10 cm未破裂的颗粒细胞瘤接受了全腹子宫切除术和双侧输卵管卵巢切除术。2.5年后复发，进行了次全切除，随后接受了六个周期的环磷酰胺、阿霉素和顺铂（CAP）化疗。二次剖腹探查时未发现疾病迹象。血清雌二醇（E2）水平与她的临床病程平行，复发时升高，化疗期间恢复到绝经后水平。四年后，E2进一步升高预示肿瘤再次复发。该患者接受了减瘤手术并已恢复化疗。回顾了其他少数接受多药化疗的患者的报告。几种联合方案似乎有效，CAP方案的毒性可能较小。与放疗相比，化疗可能使复发性颗粒细胞瘤患者存活时间更长，但实际治愈仍然难以实现。
