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[贝伐单抗联合mFOLFOX6方案成功治疗阑尾杯状细胞类癌——病例报告]

[Appendiceal Goblet Cell Carcinoid Successfully Treated with Bevacizumab plus mFOLFOX6 Regimen-A Case Report].

作者信息

Ueno Ayako, Yokota Mitsuru, Terada Kazuhiro, Hashida Kazuki, Nagahisa Yoshio, Yamaguchi Kazushige, Okabe Michio, Kawamoto Kazuyuki

机构信息

Dept. of Surgery, Kurashiki Central Hospital.

出版信息

Gan To Kagaku Ryoho. 2020 May;47(5):839-842.

Abstract

A 67-year-old man presented with abdominal distention and vomiting.Computed tomography revealed bowel obstruction due to a cecal tumor.We performed laparoscopic ileocecal resection after decompression with an ileus tube. Intraoperative findings included multiple disseminated nodules on the mesenterium surrounding the cecal tumor.The histopathologic diagnosis was poorly differentiated adenocarcinoma, which consisted of glandular proliferation of atypical epithelial cells and dispersed infiltration of goblet cells. Immunohistochemistry showed positively stained neuroendocrine markers, such as CD56, chromogranin, and synaptophysin.The patient was diagnosed with goblet cell carcinoid of the appendix and treated with combination chemotherapy of bevacizumab, fluorouracil, folinic acid, and oxaliplatin.He remained free from progression for over 1 and half years with this treatment.Subsequent chemotherapy was ineffective, and he passed away.There is no established chemotherapy regimen for goblet cell carcinoid, which has the aspects of both adenocarcinoma and neuroendocrine tumors.However, the present case suggested the efficacy of the mFOLFOX6 regimen in combination with bevacizumab for appendiceal goblet cell carcinoid.

摘要

一名67岁男性因腹胀和呕吐就诊。计算机断层扫描显示盲肠肿瘤导致肠梗阻。我们在使用肠梗阻导管减压后进行了腹腔镜回盲部切除术。术中发现包括盲肠肿瘤周围肠系膜上有多个播散性结节。组织病理学诊断为低分化腺癌,由非典型上皮细胞的腺管增生和杯状细胞的散在浸润组成。免疫组织化学显示神经内分泌标志物如CD56、嗜铬粒蛋白和突触素呈阳性染色。该患者被诊断为阑尾杯状细胞类癌,并接受了贝伐单抗、氟尿嘧啶、亚叶酸和奥沙利铂的联合化疗。经此治疗,他在超过一年半的时间里病情无进展。随后的化疗无效,他去世了。对于兼具腺癌和神经内分泌肿瘤特征的杯状细胞类癌,尚无既定的化疗方案。然而,本病例提示mFOLFOX6方案联合贝伐单抗对阑尾杯状细胞类癌有效。

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