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肺泡软组织肉瘤胰腺及脾脏转移灶切除术:一例报告

Resection of pancreatic and splenic metastases from alveolar soft part sarcoma: a case report.

作者信息

Arakawa Satoshi, Asano Yukio, Kawabe Norihiko, Nagata Hidetoshi, Kondo Yuka, Furuta Shinpei, Shimura Masahiro, Hayashi Chihiro, Ochi Takayuki, Kamio Kenshiro, Kawai Toki, Yasuoka Hironobu, Higashiguchi Takahiko, Ishihara Shin, Ito Masahiro, Imaeda Yoshihiro, Horiguchi Akihiko

机构信息

Department of Gastroenterological Surgery, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa-ku, Nagoya, Aichi, 454-8509, Japan.

出版信息

Surg Case Rep. 2020 Jun 17;6(1):139. doi: 10.1186/s40792-020-00907-9.

Abstract

BACKGROUND

We present a case of pancreatic and splenic metastases following alveolar soft part sarcoma (ASPS), which was successfully treated by surgery.

CASE PRESENTATION

A 41-year-old male was referred to our hospital in 2012. Computed tomography (CT) showed the presence of a pancreatic tumor. In 2002, the patient had undergone surgical resection of an ASPS of the anal region. In 2009, during follow-up, CT revealed lung metastases, which prompted surgical resection of the lung, followed by resection of the head skin in 2011. Abdominal ultrasonography (US) revealed the presence of isodense masses sized 34 mm in the pancreatic head and 60 mm within the spleen. The contrast-enhanced US revealed a solitary lesion with enhancement. Contrast-enhanced CT revealed solitary lesions with enhancement within the pancreatic head, spleen, and liver. The patient underwent metastasectomies from the pancreas, spleen, and liver. The patient was discharged on postoperative day 22 without recurrence for 18 months after metastasectomy. Twelve years after primary resection and 2 years after metastasectomy, the patient died as a consequence of multiple metastases.

CONCLUSIONS

We have presented a rare case of pancreatic and spleen metastases from ASPS. Resection by radical metastasectomy was successful without morbidity. Thus, for improved survival of patients with multiple metastases from ASPS, metastasectomy may be indicated. If multiple metastases are resectable, surgical approaches may be the preferred treatment.

摘要

背景

我们报告一例肺泡软组织肉瘤(ASPS)发生胰腺和脾脏转移后经手术成功治疗的病例。

病例介绍

一名41岁男性于2012年转诊至我院。计算机断层扫描(CT)显示存在胰腺肿瘤。2002年,该患者接受了肛门区域ASPS的手术切除。2009年随访期间,CT显示肺转移,促使患者接受肺手术切除,随后于2011年切除头部皮肤。腹部超声(US)显示胰头有大小为34毫米的等密度肿块,脾脏内有60毫米的等密度肿块。超声造影显示有一个强化的孤立病变。增强CT显示胰头、脾脏和肝脏内有强化的孤立病变。患者接受了胰腺、脾脏和肝脏的转移灶切除术。患者术后第22天出院,转移灶切除术后18个月无复发。在初次切除12年后和转移灶切除术后2年,患者因多发转移而死亡。

结论

我们报告了一例罕见的ASPS胰腺和脾脏转移病例。通过根治性转移灶切除术成功切除,且无并发症。因此,为提高ASPS多发转移患者的生存率,可考虑行转移灶切除术。如果多发转移灶可切除,手术方法可能是首选治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/219e/7300166/ac7e06ca1520/40792_2020_907_Fig1_HTML.jpg

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