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[一例复发性卵巢癌肉瘤长期生存的病例及文献复习]

[A case and literature review of ovarian carcinosarcoma with long-term survival after repeated recurrences].

作者信息

Asano Maki, Hasegawa Kiyoshi, Tsukada Kazuhiko, Tada Shin, Mizoguchi Yoshikazu, Imaeda Yoshihiro, Ikeda Mina, Kawamura Kyoko, Fujii Takuma

机构信息

Dept. of Obstetrics and Gynecology,Fujita Health University, Banbuntane Hotokukai Hospital.

出版信息

Gan To Kagaku Ryoho. 2014 Aug;41(8):1031-6.

Abstract

Ovarian carcinosarcoma is a rare and aggressive tumor with a poor prognosis. We report a case of ovarian carcinosarcoma and also review the literature. In 2000, a 63-year-old woman underwent optimal cytoreductive surgery for ovarian carcinosarcoma( International Federation of Gynaecology and Obstetrics[FIGO]stage III c[pT3cN0M0]). She received adjuvant chemotherapy with paclitaxel and carboplatin(TC). In 2005, a recurrent tumor was noted anterior to the sacrum. The patient had a complete response after 6 cycles of TC chemotherapy; however, a year later, the tumor recurred and was resected. In 2013, the tumor recurred adjacent to the right kidney and was surgically removed after a partial response to 3 cycles of TC chemotherapy. The pathologic findings included epithelial and non-epithelial components with histologic variation and differentiation; specifically, a leiomyosarcoma, cartilaginous tissues with cellular atypia, and a rhabdomyosarcoma were identified in specimens obtained during the first, second, and third surgical procedures, respectively. In keeping with the combination theory of histogenesis, the ovarian carcinosarcoma described herein may have originated from a monoclonal stem cell. The long survival of this patient is attributed to optimal cytoreduction during the primary operation, solitary recurrent tumors that were completely resected, and sensitivity to chemotherapy.

摘要

卵巢癌肉瘤是一种罕见的侵袭性肿瘤,预后较差。我们报告一例卵巢癌肉瘤病例并复习相关文献。2000年,一名63岁女性因卵巢癌肉瘤接受了最佳肿瘤细胞减灭术(国际妇产科联盟[FIGO]分期III c[pT3cN0M0])。她接受了紫杉醇和卡铂(TC)辅助化疗。2005年,在骶骨前方发现复发性肿瘤。患者在接受6个周期的TC化疗后获得完全缓解;然而,一年后肿瘤复发并接受了手术切除。2013年,肿瘤在右肾旁复发,在对3个周期的TC化疗部分缓解后接受了手术切除。病理结果包括具有组织学变异和分化的上皮和非上皮成分;具体而言,在第一次、第二次和第三次手术获取的标本中分别鉴定出平滑肌肉瘤、具有细胞异型性的软骨组织和横纹肌肉瘤。根据组织发生的联合理论,本文所述的卵巢癌肉瘤可能起源于单克隆干细胞。该患者的长期生存归因于初次手术时最佳的肿瘤细胞减灭、完全切除的孤立复发性肿瘤以及对化疗的敏感性。

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