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肺转移性上皮样滋养细胞肿瘤:一例报告

Metastatic epithelioid trophoblastic tumor of the lung: A case report.

作者信息

Lei Wangjun, Zhang Fangbiao, Zheng Chunhui, Zhao Chun, Tu Shaosong, Bao Yingwei

机构信息

Department of Radiology, Suichang People's Hospital, Suichang Department of Cardiothoracic Surgery, Zhejiang University, Lishui Central Hospital, Lishui, Zhejiang, P.R. China.

出版信息

Medicine (Baltimore). 2018 Apr;97(16):e0306. doi: 10.1097/MD.0000000000010306.

Abstract

RATIONALE

Epithelioid trophoblastic tumor (ETT) is a very rare form of gestational trophoblastic disease (GTD) which arises from neoplastic proliferation of intermediate trophoblasts. Metastatic ETT of the lung is extremely rare in postmenopausal women.

PATIENT CONCERNS

Here we describe a 50-year-old woman with a metastatic ETT of the lung showing increasing tracer uptake at PET/CT.

DIAGNOSIS

Hematoxylin-eosin staining showed a tumor composed of nests of epithelioid cells with necrotic debris and peritumoral hyaline-like material. Immunohistochemical staining of the tumor cells was positive for human chorionic gonadotropin (HCG) and cytokeratin 18.

INTERVENTIONS

The patient underwent thoracoscopic lower left lobectomy combined with mediastinal lymphadenectomy. At surgery, a solid mass (size 3.0 × 3.0 cm) was found in the left lower lung.

OUTCOMES

The patient was discharged on the tenth day postsurgery, following an uneventful recovery. Three months postsurgery, the patient was asymptomatic and is currently being managed with close follow-up.

LESSONS

Metastatic ETT of lung is a very rare disease. Complete surgical resection and chemotherapy may be the critical therapeutic option.

摘要

原理

上皮样滋养细胞肿瘤(ETT)是妊娠滋养细胞疾病(GTD)的一种非常罕见的形式,由中间型滋养细胞的肿瘤性增殖引起。绝经后女性发生肺转移性ETT极为罕见。

患者情况

在此,我们描述一名50岁女性,患有肺转移性ETT,在PET/CT检查中示踪剂摄取增加。

诊断

苏木精-伊红染色显示肿瘤由巢状上皮样细胞组成,伴有坏死碎片和肿瘤周围透明样物质。肿瘤细胞免疫组化染色人绒毛膜促性腺激素(HCG)和细胞角蛋白18呈阳性。

干预措施

患者接受了胸腔镜下左下肺叶切除术联合纵隔淋巴结清扫术。手术中,在左下肺发现一个实性肿块(大小3.0×3.0 cm)。

结果

患者术后第十天顺利出院。术后三个月,患者无症状,目前正在密切随访中。

经验教训

肺转移性ETT是一种非常罕见的疾病。完整的手术切除和化疗可能是关键的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c71b/5916664/2f2781645866/medi-97-e0306-g001.jpg

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