Shirafuji Aya, Shinagawa Akiko, Kurokawa Tetsuji, Yoshida Yoshio
Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan ; Department of Obstetrics and Gynecology, Fukui Aiiku Hospital, Fukui, Japan.
Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Oncol Lett. 2014 Aug;8(2):637-641. doi: 10.3892/ol.2014.2193. Epub 2014 May 28.
Advanced uterine leiomyosarcoma (LMS) is a rare and extremely aggressive disease. In patients with advanced and unresected uterine LMS, multidisciplinary therapy is the best treatment option, although no consensus exists on the efficacy of the treatment. The present study describes the case of a 41-year-old female who underwent laparotomy due to a large uterine tumor. Exploratory laparotomy revealed a large tumor that had extended from the pelvic wall to the outside of the pelvis and then invaded the colon. Large residual tumors remained present in the pelvis following suboptimal debulking surgery. Subsequent to surgery, the patient was treated with adjuvant radiotherapy, followed by chemotherapy with regional whole pelvis hyperthermia (HT). Computed tomography revealed stable disease prior and subsequent to combination treatment. While treatment was being administered for third/fourth-degree burns and subcutaneous fatty necrosis, the patient developed multi-organ failure and succumbed. The present case report describes the potential for using a combination of chemotherapy, HT and radiotherapy in patients with LMS. The development of an effective protocol is required for the administration of chemotherapy, HT and radiotherapy in patients with advanced unresected LMS.
晚期子宫平滑肌肉瘤（LMS）是一种罕见且极具侵袭性的疾病。对于晚期且未切除的子宫LMS患者，多学科治疗是最佳治疗选择，尽管对于该治疗的疗效尚无共识。本研究描述了一名41岁女性因巨大子宫肿瘤接受剖腹手术的病例。剖腹探查发现一个巨大肿瘤，已从盆腔壁延伸至盆腔外并侵犯了结肠。在进行了不太理想的肿瘤减灭手术后，盆腔内仍残留大量肿瘤。手术后，患者接受了辅助放疗，随后进行了联合区域全盆腔热疗（HT）的化疗。计算机断层扫描显示联合治疗前后病情稳定。在治疗三度/四度烧伤和皮下脂肪坏死期间，患者出现多器官功能衰竭并死亡。本病例报告描述了在LMS患者中联合使用化疗、HT和放疗的可能性。对于晚期未切除LMS患者，需要制定有效的化疗、HT和放疗方案。
