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乙状结肠原发性绒毛膜癌 1 例罕见报告

A rare case of primary choriocarcinoma in the sigmoid colon.

机构信息

Hiromitsu Maehira, Tomoharu Shimizu, Hiromichi Sonoda, Eiji Mekata, Tomoharo Yamaguchi, Tohru Miyake, Tohru Tani, Department of Surgery, Shiga University of Medical Science, Shiga 520-2192, Japan.

出版信息

World J Gastroenterol. 2013 Oct 21;19(39):6683-8. doi: 10.3748/wjg.v19.i39.6683.

Abstract

Primary colorectal choriocarcinoma is an extremely rare neoplasm and is usually associated with a poor prognosis. Only 13 cases of colorectal choriocarcinoma have previously been reported. There is no standard chemotherapeutic regimen for this tumor type. A 68-year-old man presented with melena and was diagnosed with sigmoid colonic adenocarcinoma with multiple liver metastases. He underwent a laparoscopic sigmoidectomy. Pathology revealed choriocarcinoma with a focal component of moderately differentiated adenocarcinoma of colon origin. Based on the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) results, mFOLFOX6 and bevacizumab were administered, which suppressed aggressive tumor growth for 4 mo. The patient died 9 mo after the initial diagnosis. Our study results suggest that the standard chemotherapy regimen for colorectal cancer might have suppressive effects against primary colorectal choriocarcinoma. Moreover, CD-DST may provide, at least in part, therapeutic insight for the selection of appropriate antitumor agents for such patients.

摘要

原发性结直肠绒毛膜癌是一种极为罕见的肿瘤,通常预后不良。此前仅报道过 13 例结直肠绒毛膜癌。对于这种肿瘤类型,尚无标准的化疗方案。一名 68 岁男性因黑便就诊,被诊断为乙状结肠腺癌伴多发肝转移。他接受了腹腔镜乙状结肠切除术。病理检查显示为绒毛膜癌,局部有结肠来源的中分化腺癌成分。根据胶原凝胶微滴嵌入培养药物敏感性试验(CD-DST)结果,给予 mFOLFOX6 和贝伐珠单抗治疗,抑制了侵袭性肿瘤生长 4 个月。患者在初次诊断后 9 个月死亡。我们的研究结果表明,结直肠癌的标准化疗方案可能对原发性结直肠绒毛膜癌有抑制作用。此外,CD-DST 至少在一定程度上为选择合适的抗肿瘤药物提供了治疗思路。

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