Kawaguchi Takeshi, Kawai Norikazu, Watanabe Takashi, Yasukawa Motoaki, Morita Kohei, Ohbayashi Chiho, Tojo Takashi
Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Department of Diagnostic Pathology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Surg Case Rep. 2015 Dec;1(1):6. doi: 10.1186/s40792-014-0013-1. Epub 2015 Jan 28.
We present three patients with intrathoracic malignant neurogenic tumor. Two lesions showed no sign of invasion into adjacent structures, while the third lesion extended to the intraspinal canal with vertebral involvement. Although all three lesions were completely excised, each patient relapsed within 1 year of the initial treatment. One patient with local recurrence underwent radiation therapy, but the recurrent tumor continued to progress. Chemotherapy was subsequently performed. Two patients with distant metastases also received chemotherapy. Because there is no effective chemotherapeutic regimen for intrathoracic malignant neurogenic tumor, all three patients received high-dose chemotherapy followed by hematopoietic stem cell transplantation. Although the relapsed lesions temporarily regressed after treatment, all three patients showed disease recrudescence and ultimately died of their disease. A comparison of the intrathoracic malignant neurogenic tumors and the benign neurogenic tumors resected at our institution revealed no meaningful differences distinguishing malignant from benign neurogenic tumors prior to surgery.
我们报告了3例胸内恶性神经源性肿瘤患者。2个病灶未显示侵犯相邻结构的迹象,而第3个病灶延伸至椎管并累及椎体。尽管所有3个病灶均被完全切除,但每位患者在初始治疗后1年内均复发。1例局部复发患者接受了放射治疗,但复发性肿瘤继续进展。随后进行了化疗。2例远处转移患者也接受了化疗。由于尚无针对胸内恶性神经源性肿瘤的有效化疗方案,所有3例患者均接受了大剂量化疗,随后进行了造血干细胞移植。尽管治疗后复发病灶暂时消退,但所有3例患者均出现疾病复发,最终死于该疾病。对我院切除的胸内恶性神经源性肿瘤和良性神经源性肿瘤进行比较,发现在手术前区分恶性和良性神经源性肿瘤没有有意义的差异。