Tapia Rico Gonzalo, Klevansky Myron, Townsend Amanda, Price Timothy
Medical Oncology, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-220008. doi: 10.1136/bcr-2017-220008.
Synovial metastasis is an unusual entity in solid tumours and only a few cases have been reported in the literature. We report a case of synovial metastasis of the knee in a young patient with progressive rectal adenocarcinoma and review previously published case reports of synovial involvement in advanced colorectal carcinomas. Synovial metastasis is just one of the multiple possibilities of differential diagnosis in patients with cancer suffering from monarthritis. Radiological tests (plain radiographs, bone scans, MRI of the joint and so forth) can be unspecific and cytological examination of the synovial fluid and/or histology of synovial biopsies is essential for a definitive diagnosis so as to tailor the best treatment for patients. Given the poor prognosis associated with these intra-articular secondaries, treatment is often limited to palliation.
滑膜转移在实体瘤中是一种罕见情况,文献中仅报道过少数病例。我们报告了一例年轻的进展期直肠腺癌患者发生膝关节滑膜转移的病例,并回顾了先前发表的关于晚期结直肠癌滑膜受累的病例报告。滑膜转移只是患单关节炎的癌症患者鉴别诊断的多种可能情况之一。放射学检查(X线平片、骨扫描、关节MRI等)可能不具有特异性,滑膜液的细胞学检查和/或滑膜活检的组织学检查对于明确诊断至关重要,以便为患者制定最佳治疗方案。鉴于这些关节内继发性病变预后较差,治疗通常限于姑息治疗。