Tian Guo, Jiang Tian'an
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.
Medicine (Baltimore). 2017 Apr;96(15):e6597. doi: 10.1097/MD.0000000000006597.
Retroperitoneal metastatic lymph node is rare but severe, which has important structures like the gastrointestinal tract and large blood vessels around and may challenge excision, inducing serious complications like hemorrhage, intestinal adhesion, and even death after injury.
We described the case of a 60-year-old man with a history of right liver resection in 2010, pulmonary wedge resection in 2012, and transarterial chemoembolization twice in 2014, in which the postoperative pathology suggested the mixed liver cancer, and poorly differentiated lung cancer from liver metastasis.
Preoperative magnetic resonance (MR) imaging scan showed a refractory retroperitoneal metastatic lymph node.
Then this patient repeatedly received 4 ablations with US-guided laser ablation within a month.
After 4 ablations due to residual tumor, MR, and CT images of 5-month follow-up showed the partial response. No obvious side effects were discovered in this case during these procedures.
This suggested US-guided laser ablation appears to be a useful technique for retroperitoneal metastatic lymph node with poor general condition or those refusing surgical therapy.
腹膜后转移性淋巴结罕见但严重,其周围有胃肠道和大血管等重要结构,可能给切除带来挑战,导致出血、肠粘连等严重并发症,甚至术后死亡。
我们描述了一名60岁男性的病例,他在2010年接受了右肝切除术,2012年接受了肺楔形切除术,并在2014年接受了两次经动脉化疗栓塞术,术后病理提示为混合性肝癌,且为来自肝脏转移的低分化肺癌。
术前磁共振成像扫描显示为难治性腹膜后转移性淋巴结。
然后该患者在一个月内反复接受了4次超声引导下的激光消融术。
由于残留肿瘤进行4次消融后,5个月随访的磁共振成像和计算机断层扫描图像显示部分缓解。在此过程中该病例未发现明显副作用。
这表明超声引导下的激光消融术对于一般状况较差或拒绝手术治疗的腹膜后转移性淋巴结似乎是一种有用的技术。