Mishima T, Taneda S, Johdo S, Sakai K, Ishizuka T, Nishikawa T, Miwa A, Takashiro T, Shimoyama K, Horiguchi Y
Dept. of Int. Med., Kushiro Red Cross Hospital.
Gan No Rinsho. 1989 Aug;35(9):1061-6.
Discussed is a 34-year-old man who hospitalized for manifesting the superior vena cava syndrome. Chest radiograph and chest CT scan revealed a gross tumor shadow in the superior mediastinum and a tiny shadow in the right lung. Superior vena cavography showed intimal stenosis, irregularities, and stiffness of the superior vena cava. Thus, radiotherapy applied to primary lesion of the mediastinum was provided to relieve his complaints. One year later, predominant metastatic pulmonary lesions and skin lesions developed. Light and electron microscopic findings of a biopsied specimen of the skin lesion were consistent with leiomyosarcoma. CYVADIC combination chemotherapy reduced the pulmonary metastatic lesions dramatically. The literature of mediastinal leiomyosarcoma is reviewed and the origin of this tumor is discussed.
讨论的是一名34岁男性,因出现上腔静脉综合征而住院。胸部X线片和胸部CT扫描显示上纵隔有一个巨大肿瘤阴影,右肺有一个微小阴影。上腔静脉造影显示上腔静脉内膜狭窄、不规则和僵硬。因此,对纵隔原发性病变进行了放射治疗以缓解他的症状。一年后,出现了主要的肺转移病变和皮肤病变。皮肤病变活检标本的光镜和电镜检查结果与平滑肌肉瘤一致。CYVADIC联合化疗显著减少了肺转移病变。回顾了纵隔平滑肌肉瘤的文献并讨论了该肿瘤的起源。