Kanayama Seiji, Yamada Yoshihiko, Tanase Yasuhito, Haruta Shoji, Nagai Akira, Kawaguchi Ryuji, Yoshida Shozo, Furukawa Naoto, Oi Hidekazu, Kobayashi Hiroshi
Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Nara, Kashihara 634-8522, Japan.
Case Rep Obstet Gynecol. 2012;2012:961087. doi: 10.1155/2012/961087. Epub 2012 Dec 26.
We report a case of ovarian carcinoid tumor that recurred with multiple liver metastases and was successfully treated with chemoembolization. A 76-year-old woman was admitted to our hospital presented with abdominal distension and abnormal uterine bleeding for about 6 months. She presented with hyperestrogenic and androgenic manifestations such as vaginal bleeding with endometrial hyperplasia and hirsutism. Magnetic resonance (MR) imaging revealed a large solid and cystic ovarian tumor of 17 cm at maximum diameter. On the basis of the clinical diagnosis of sex cord stromal tumor containing a mature cystic teratoma, she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. The pathology report revealed that the mass in the left ovary was a carcinoid tumor, insular type, with mature cystic teratoma. Two years after surgical treatment, multiple liver metastases were revealed by abdominal CT. Hepatic arterial infusion of cisplatin was performed for 2 courses, and multiple metastatic nodules have remarkably reduced. No established chemotherapy or radiation therapy treatments are currently available for recurrent or advanced carcinoid tumors. Our paper suggests that chemoembolization with cisplatin may be effective in treatment of patients with multiple liver metastases of ovarian carcinoid tumor.
我们报告一例卵巢类癌肿瘤复发并伴有多发肝转移,经化疗栓塞成功治疗的病例。一名76岁女性因腹胀及异常子宫出血约6个月入院。她出现了雌激素过多和雄激素过多的表现,如伴有子宫内膜增生的阴道出血和多毛症。磁共振成像显示一个最大直径为17厘米的巨大实性和囊性卵巢肿瘤。基于临床诊断为含有成熟囊性畸胎瘤的性索间质肿瘤,她接受了全腹子宫切除术和双侧输卵管卵巢切除术。病理报告显示左卵巢肿物为岛状型类癌肿瘤,伴有成熟囊性畸胎瘤。手术治疗两年后,腹部CT显示多发肝转移。进行了2个疗程的肝动脉顺铂灌注,多个转移结节明显缩小。目前对于复发或晚期类癌肿瘤尚无既定的化疗或放疗治疗方法。我们的论文表明,顺铂化疗栓塞可能对治疗卵巢类癌肿瘤多发肝转移患者有效。