Muntz H G, Rutgers J L, Tarraza H M, Fuller A F
Department of Gynecology, Harvard Medical School, Boston, Massachusetts.
Gynecol Oncol. 1989 Jul;34(1):109-15. doi: 10.1016/0090-8258(89)90119-4.
Four cases of carcinosarcoma and mixed müllerian tumors of the fallopian tube are presented. Each patient presented with abnormal bleeding and a pelvic mass. All underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, staging, and cytoreduction. Disease was limited to the pelvis in two patients, analogous to FIGO stage IIB ovarian carcinoma; the other two patients had upper abdominal disease, analogous to FIGO stage III. The primary tumors were intraluminal and papillary. There were equal amounts of carcinoma and sarcoma in three tumors; in one, sarcoma constituted only a small intraluminal focus. The sarcoma was predominantly homologous, with foci of heterologous elements present in three tumors. Adjuvant therapy consisted of pelvic radiation in two patients. One patient died of inanition within one year of diagnosis. The other patient, who had the small focus of sarcoma within a stage IIB carcinoma, had an 11-year disease-free interval before retroperitoneal recurrence of carcinoma. Two patients received chemotherapy. A stage IIB patient, after pelvic radiation, received Cytoxan and Adriamycin; she is clinically free of disease after 6 years. A stage III patient lived over 3 years after treatment with multiple agents; she responded to Cytoxan and cis-platinum before suffering a systemic relapse and death.
本文报告了4例输卵管癌肉瘤及混合性苗勒管肿瘤。每位患者均表现为异常出血和盆腔肿块。所有患者均接受了全腹子宫切除术、双侧输卵管卵巢切除术、分期手术及肿瘤细胞减灭术。2例患者疾病局限于盆腔，类似于国际妇产科联盟（FIGO）IIB期卵巢癌；另外2例患者有上腹部疾病，类似于FIGO III期。原发性肿瘤位于管腔内，呈乳头状。3例肿瘤中癌和肉瘤的含量相等；1例中，肉瘤仅构成一小部分管腔内病灶。肉瘤主要为同源性，3例肿瘤中有异源性成分灶。辅助治疗包括2例患者接受盆腔放疗。1例患者在诊断后1年内死于营养不良。另1例患者，其IIB期癌内有小的肉瘤病灶，在癌腹膜后复发前有11年的无病间期。2例患者接受了化疗。1例IIB期患者在盆腔放疗后接受了环磷酰胺和阿霉素治疗；6年后临床无病。1例III期患者在接受多种药物治疗后存活了3年多；她在全身复发和死亡前对环磷酰胺和顺铂有反应。
