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1例经新辅助化疗后完全切除的原发性肺平滑肌肉瘤。

A case of primary pulmonary leiomyosarcoma completely resected after neoadjuvant chemotherapy.

作者信息

Tanaka Kazuhisa, Iwata Takekazu, Nishii Kai, Matsui Yukiko, Yonemoto Tsukasa, Kawana Hidetada, Itami Makiko, Yoshida Shigetoshi, Iizasa Toshihiko

机构信息

Division of Thoracic Surgery, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan.

Division of Orthopedic Surgery, Chiba Cancer Center, Chiba, Japan.

出版信息

Surg Case Rep. 2019 May 31;5(1):91. doi: 10.1186/s40792-019-0649-y.

Abstract

BACKGROUND

Primary pulmonary leiomyosarcoma is a rare malignant tumor. We herein report a case of primary pulmonary leiomyosarcoma that was completely resected by surgery after neoadjuvant chemotherapy.

CASE PRESENTATION

A 60-year-old man presented with cough. Chest computed tomography showed an 11-cm mass in the right upper lobe of the lung that had invaded the superior vena cava. Endobronchial ultrasound-guided transbronchial needle aspiration revealed leiomyosarcoma of the lung. We considered complete resection of the tumor to be very difficult because of the tumor invasion into the right atrium inflow of the superior vena cava, so we performed chemotherapy using doxorubicin for five cycles. After chemotherapy, the tumor size decreased to 5.6 cm, and we performed right upper lobectomy with combined resection of the superior vena cava. The tumor was completely resected by surgery. The patient is alive without recurrence 17 months postoperatively.

CONCLUSIONS

We encountered a case of primary pulmonary leiomyosarcoma that was successfully treated by surgery after neoadjuvant chemotherapy. Doxorubicin monotherapy was effective in this case. Surgery combined with neoadjuvant chemotherapy should be considered for such cases, as a long-term survival can be achieved by complete resection of primary pulmonary leiomyosarcoma.

摘要

背景

原发性肺平滑肌肉瘤是一种罕见的恶性肿瘤。我们在此报告一例原发性肺平滑肌肉瘤患者,该患者在新辅助化疗后通过手术完全切除。

病例介绍

一名60岁男性因咳嗽就诊。胸部计算机断层扫描显示右肺上叶有一个11厘米的肿块,已侵犯上腔静脉。支气管内超声引导下经支气管针吸活检显示为肺平滑肌肉瘤。由于肿瘤侵犯上腔静脉的右心房流入处,我们认为完全切除肿瘤非常困难,因此我们使用阿霉素进行了五个周期的化疗。化疗后,肿瘤大小降至5.6厘米,我们进行了右上叶切除术并联合切除上腔静脉。肿瘤通过手术完全切除。患者术后17个月存活且无复发。

结论

我们遇到一例原发性肺平滑肌肉瘤患者,在新辅助化疗后通过手术成功治疗。阿霉素单药治疗在该病例中有效。对于此类病例,应考虑手术联合新辅助化疗,因为通过完全切除原发性肺平滑肌肉瘤可实现长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3157/6544680/477b34bf44fd/40792_2019_649_Fig1_HTML.jpg

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