Inatsu Hiroki, Murata Taro, Tokunaga Mayuko, Nyomura Shizue, Takahashi Naoko, Kondo Yukihiro, Tomita Kyoichi
Nihon Hinyokika Gakkai Zasshi. 2015 Jul;106(3):211-5. doi: 10.5980/jpnjurol.106.211.
The patient was a 37-year-old woman who had suffered from repeated pyelonephritis. Computed tomography (CT) of the abdomen revealed a 1.9 cm retroperitoneal mass with compression of the right ureter and hydronephrosis. The patient visited our medical center and admitted. The patient underwent a simple total excision of the mass and end-to-end ureteral anastomosis. The tumor involved right ovarian vein and right ureter. Histopathological diagnosis was leiomyosarcoma of the ovarian vein. At 12 months after operation, local recurrence of surroundings tissue of the right ureter and gallbladder, and inferior vena cava invasion is found. Thus, the patient underwent a right nephroureterectomy with partly resection of the inferior vena cava and en block excision of the gallbladder. While CT revealed no recurrence three months after the operation, adjuvant postoperative combination chemotherapy with gemcitabine and docetaxel was administered. Nine cases of this leiomyosarcoma arising from ovarian vein have been reported in the literature. Leiomyosarcoma arising from ovarian vein with hydronephrosis is a second example.
该患者为一名37岁女性,曾反复患肾盂肾炎。腹部计算机断层扫描(CT)显示一个1.9厘米的腹膜后肿块,压迫右输尿管并导致肾积水。患者前来我们的医疗中心并入院。患者接受了肿块的单纯全切术及输尿管端端吻合术。肿瘤累及右卵巢静脉和右输尿管。组织病理学诊断为卵巢静脉平滑肌肉瘤。术后12个月,发现右输尿管和胆囊周围组织局部复发,并侵犯下腔静脉。因此,患者接受了右肾输尿管切除术,部分切除下腔静脉并整块切除胆囊。虽然术后三个月CT显示无复发,但仍给予吉西他滨和多西他赛辅助术后联合化疗。文献中已报道9例起源于卵巢静脉的这种平滑肌肉瘤。起源于卵巢静脉并伴有肾积水的平滑肌肉瘤是第二例。