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根治性切除术后胆囊原发性癌肉瘤的手术结果:罕见病例系列

Surgical outcomes of primary carcinosarcoma of the gallbladder after curative resection: A rare case series.

作者信息

Aldossary Mohammed Yousef, AlQattan Abdullah Saleh, Alghamdi Yasmeen Megad, Alayed Amal A, Alquraish Fatimah, AlAnzi Omar Abdulaziz, Alabdulrahim Nawaf, Alateeq Abdulaziz, Alqahtani Mohammed Saad

机构信息

Department of General Surgery, Hepatobiliary Surgery Unit, King Fahad Specialist Hospital-Dammam, Saudi Arabia.

Department of General Surgery, Hepatobiliary Surgery Unit, King Fahad Specialist Hospital-Dammam, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2019;65:32-39. doi: 10.1016/j.ijscr.2019.10.056. Epub 2019 Oct 29.

Abstract

INTRODUCTION

Primary carcinosarcoma is a rare neoplasm of the gallbladder, and is characterized by collision elements of the adenocarcinomatous and sarcomatous components. The tumours comprise both malignant epithelial and mesenchymal elements, and are usually very aggressive, conferring poor prognosis. Adenocarcinomas are the most common neoplasms of the gall bladder, while carcinosarcoma are extremely rare, with a global prevalence rate of less than 1%. The low incidence of carcinosarcoma greatly hinders the understanding of its aetiology.

PRESENTATION OF CASE

Here, we report the surgical outcome of 3 rare cases of gallbladder carcinosarcomas, two of which had a IVB stage disease and in one case the staging was II. Following surgery, the survival in the former was less than 1 year, while in the latter, it extended up to 7 years (86 months), and the patient is alive till date. This study aimed to elucidate the surgical outcomes and prognosis after curable resection for carcinosarcomas of the gallbladder.

DISCUSSION

The findings suggest that carcinosarcomas are associated with a poor prognosis and short survival, particularly in those with tumours of >5 cm. In the absence of effective adjuvant treatment, surgery remains the mainstay of treatment.

CONCLUSION

Complete surgical resection may improve prognosis and extend survival in patients with this rare and aggressive form of gallbladder cancer.

摘要

引言

原发性癌肉瘤是一种罕见的胆囊肿瘤,其特征是腺癌成分和肉瘤成分相互碰撞。这些肿瘤包含恶性上皮和间充质成分,通常具有很强的侵袭性,预后较差。腺癌是胆囊最常见的肿瘤,而癌肉瘤极为罕见,全球患病率不到1%。癌肉瘤的低发病率极大地阻碍了对其病因的了解。

病例介绍

在此,我们报告3例罕见的胆囊癌肉瘤的手术结果,其中2例为IVB期疾病,1例分期为II期。手术后,前者的生存期不到1年,而后者延长至7年(86个月),患者至今仍存活。本研究旨在阐明胆囊癌肉瘤可切除术后的手术结果和预后。

讨论

研究结果表明,癌肉瘤预后较差,生存期短,尤其是肿瘤>5 cm的患者。在缺乏有效辅助治疗的情况下,手术仍然是主要的治疗方法。

结论

对于这种罕见且侵袭性强的胆囊癌患者,完整的手术切除可能改善预后并延长生存期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b305/6838533/6ae0211dc895/gr1.jpg

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