Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan.
Department of Pathology, Dokkyo Medical University School of Medicine, Tochigi, Japan.
J Chemother. 2020 Dec;32(8):445-450. doi: 10.1080/1120009X.2020.1767477. Epub 2020 May 20.
Histiocytic sarcoma (HS), an extremely rare malignancy, usually follows a progressive time course, and patients die within two years of diagnosis. At present, there is no consensus for effective chemotherapy. We report the case of a 54-year-old man who presented with low back pain and left hip joint pain. Imaging for the pain revealed multiple lesions in the mediastinum, vertebral bodies, and left ilium. Biopsies of the mediastinal and vertebral lesions yielded a diagnosis of soft tissue sarcoma. He received standard chemotherapy for sarcoma with doxorubicin and ifosfamide, as the initial pathological diagnosis was soft tissue sarcoma. This is called AI therapy and commonly used for soft tissue sarcoma. Palliative radiation therapy to the left iliac lesion was added for pain control. Complete remission (CR) was achieved after two courses of AI therapy. Subsequent immunopathological examination revealed that the tumor was spindle cell dominant HS. CR was maintained for more than three years. To the best of our knowledge, this is the first report that a CR was achieved by AI therapy as first-line treatment for spindle cell dominant HS, combined with focal bone palliative irradiation. AI therapy could be an effective option as chemotherapy for HS.
组织细胞肉瘤（HS）是一种极其罕见的恶性肿瘤，通常具有进行性病程，患者在诊断后两年内死亡。目前，对于有效的化疗方案尚未达成共识。我们报告了一例 54 岁男性，因腰痛和左髋关节痛就诊。疼痛的影像学检查显示纵隔、椎体和左髂骨有多发性病变。纵隔和椎体病变的活检诊断为软组织肉瘤。他接受了多柔比星和异环磷酰胺标准的肉瘤化疗，因为最初的病理诊断为软组织肉瘤。这被称为 AI 治疗，常用于软组织肉瘤。为了控制疼痛，还对左髂骨病变进行了姑息性放射治疗。在接受了两周期 AI 治疗后，达到完全缓解（CR）。随后的免疫病理学检查显示肿瘤以梭形细胞为主的 HS。CR 维持了三年多。据我们所知，这是首例报告称，对于以梭形细胞为主的 HS，采用 AI 治疗作为一线治疗方案，联合局部骨姑息性照射，可获得 CR。AI 治疗可能是 HS 化疗的有效选择。
