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