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主支气管原发性恶性孤立性纤维瘤手术切除后多发转移复发:一例报告

Recurrence of multiple metastases after surgical removal of a primary malignant solitary fibrous tumor from the main bronchus: A case report.

作者信息

Lv Guangchao, Wang Kaizhong, Li Miao, Li Zhijun, Zheng Awangdang, Pang Qisheng

机构信息

Department of Thoracic Surgery.

Department of Pathology, First Hospital of Jilin University, Changchun, Jilin, People's Republic of China.

出版信息

Medicine (Baltimore). 2018 Dec;97(50):e13560. doi: 10.1097/MD.0000000000013560.

Abstract

RATIONALE

Limited knowledge is available regarding solitary fibrous tumors (SFTs), about 15% of which are malignant. In particular, the long-term survival of patients with malignant SFTs (mSFTs), the disease course, and the potential for recurrence of second primary tumors or distant metastases are largely undetermined.

PATIENT CONCERNS

We report a rare case in which an mSFT was found at the main bronchus of the right lung of a 37-year-old man.

DIAGNOSIS

The tumor cells of mSFT were spindle-shaped and expressed antigen Ki-67, B-cell lymphoma 2, cluster of differentiation 31, and vimentin.

INTERVENTIONS

A total pneumonectomy was performed.

OUTCOMES

The patient developed fibrosarcoma of the small intestine at 6 months, as well as extensive pleural and peritoneal metastases at 1 year, after removal of the primary mSFT from the right main bronchus.

LESSONS

From these findings, we expect that patients with primary mSFT, especially of the lung, have a high potential to develop second tumors or distant metastases. Close monitoring after surgery is necessary to improve the outcomes of these patients.

摘要

理论依据

关于孤立性纤维瘤(SFTs)的知识有限,其中约15%为恶性。特别是,恶性SFTs(mSFTs)患者的长期生存率、病程以及第二原发性肿瘤或远处转移的复发可能性在很大程度上尚未确定。

患者情况

我们报告了一例罕见病例,一名37岁男性右肺主支气管发现mSFT。

诊断

mSFT的肿瘤细胞呈梭形,表达抗原Ki-67、B细胞淋巴瘤2、分化簇31和波形蛋白。

干预措施

进行了全肺切除术。

结果

在从右主支气管切除原发性mSFT后,患者在6个月时发生小肠纤维肉瘤,1年时出现广泛的胸膜和腹膜转移。

经验教训

从这些发现来看,我们预计原发性mSFT患者,尤其是肺部患者,发生第二肿瘤或远处转移的可能性很高。术后密切监测对于改善这些患者的预后很有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eafd/6320158/ffb93f6ccc4f/medi-97-e13560-g001.jpg

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