López-Gómez Javier, Flores-Vázquez Erwin R, Salazar-Álvarez Ma Alejandra, Adame Rodrigo Y, Garcia-Ortega Dorian Y, Cuellar-Hübbe Mario
Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico.
Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico.
Int J Surg Case Rep. 2017;31:93-98. doi: 10.1016/j.ijscr.2017.01.018. Epub 2017 Jan 16.
Intimal sarcoma is an extremely rare group of undifferentiated pleomorphic sarcoma arising from the intimal layer of vessels accounting for only 1% of all sarcomas, intimal sarcoma of large veins are even less common.
We present two cases of intima sarcoma, one originated form the basilar vein and the other from the cephalic vein, the first one was treated with surgery and postoperative chemotherapy followed by Radiotherapy (RT), the second case was treated with isolated limb perfusion followed by marginal resection and RT. Both patients progressed to the lungs in a short time, the first case was treated with metastasectomy of the lung and is without evidence of disease 7months after surgery; the second case treated with isolated limb perfusion has stable disease.
Intimal sarcoma are very aggressive tumors, with a high metastatic potential, the two patients progressed to lung in a short time (2months) after local treatment. Both cases exhibit good response to chemotherapy and metastasectomy with a disease - free period of 7months.
We propose that given the aggressive behavior of these tumors, they should be treated with chemoradiotherapy postoperative, either by systemic chemotherapy or isolated limb perfusion for the limp sparing surgery in this histology.
内膜肉瘤是一种极其罕见的未分化多形性肉瘤,起源于血管内膜层,仅占所有肉瘤的1%,大静脉内膜肉瘤更为少见。
我们报告两例内膜肉瘤病例,一例起源于基底静脉,另一例起源于头静脉。第一例接受了手术、术后化疗及放疗;第二例接受了肢体隔离灌注,随后行边缘性切除及放疗。两名患者均在短期内出现肺转移,第一例接受了肺转移瘤切除术,术后7个月无疾病证据;第二例接受肢体隔离灌注治疗后病情稳定。
内膜肉瘤是极具侵袭性的肿瘤,具有高转移潜能,两名患者在局部治疗后短期内(2个月)出现肺转移。两例对化疗及转移瘤切除术均表现出良好反应,无病生存期达7个月。
鉴于这些肿瘤的侵袭性行为,我们建议术后应采用放化疗,可通过全身化疗或肢体隔离灌注进行保肢手术治疗。