Martínez-Ordaz J L, Gómez-Jiménez L M, Ballinas-Oseguera G
Servicio de Gastrocirugía, Hospital de Especialidades de Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México.
Rev Gastroenterol Mex. 2012 Jul-Sep;77(3):143-7. doi: 10.1016/j.rgmx.2012.03.005. Epub 2012 Aug 24.
Five per cent of patients presenting with choriocarcinoma develop small bowel metastasis. Tumors of the small bowel are rare and the metastases are generally from lung and breast carcinoma or from melanoma. Clinical presentation is vague and the majority of cases are autopsy findings. The main symptoms are related to the presence of abdominal tumor or hemorrhage, or bowel obstruction or perforation. We present the cases of three patients with small bowel metastasis from choriocarcinoma. A 24-year-old woman with bowel obstruction secondary to intussusception caused by a metastatic choriocarcinoma polypoid mass and two men, one 18 years old and the other 24 years old, with a history of testicular tumor, who presented with gastrointestinal bleeding due to small bowel metastasis from choriocarcinoma, 2 and 10 months after orchiectomy, respectively. Management was endoscopic in one case and surgical in the other two. Two patients died in the early postoperative period and one patient died during the first year of follow-up. Choriocarcinoma metastases are very rare and their main clinical manifestations are hemorrhage and bowel obstruction. Management can be either medical or surgical. The majority of patients with choriocarcinoma respond to chemotherapy but prognosis is worse for those patients presenting with small bowel metastasis.
患绒毛膜癌的患者中有5%会发生小肠转移。小肠肿瘤很罕见,转移瘤通常来自肺癌、乳腺癌或黑色素瘤。临床表现不明确,大多数病例是尸检结果。主要症状与腹部肿瘤、出血、肠梗阻或穿孔有关。我们报告了3例绒毛膜癌小肠转移的病例。1例24岁女性因转移性绒毛膜癌息肉样肿块导致肠套叠继发肠梗阻;另2例为男性,分别为18岁和24岁,有睾丸肿瘤病史,分别在睾丸切除术后2个月和10个月因绒毛膜癌小肠转移出现胃肠道出血。1例采用内镜治疗,另2例采用手术治疗。2例患者术后早期死亡,1例患者在随访的第一年死亡。绒毛膜癌转移非常罕见,其主要临床表现为出血和肠梗阻。治疗可采用药物或手术方法。大多数绒毛膜癌患者对化疗有反应,但小肠转移患者的预后较差。