Department of Surgery, Faculty of Medicine, University of Szeged, Semmelweis str. 8, Szeged, 6725, Hungary.
Department of Pediatric Surgery, Faculty of Medicine, University of Szeged, Koranyi alley 14-15, Szeged, 6725, Hungary.
BMC Surg. 2020 Dec 14;20(1):332. doi: 10.1186/s12893-020-01005-1.
Benign foregut cysts usually develop in the thorax most of all in the mediastinum. Rare cases involving various abdominal organs, such as liver, stomach or pancreas have been previously published, mostly occurring in the retroperitoneum.
We herein present an adenocarcinoma of a foregut cyst involving the left side of the diaphragm, left lower lobe of the lung, and left lobe of the liver, successfully removed through multivisceral resection. In between drug holidays, postoperative oncological treatment has been ongoing for nearly 4 years. In terms of chemotherapy, FOLFOX 4 regime, capacitabine monotherapy and later on next generation sequencing has been attempted, although the patient refused the later treatment option. Despite multimodality (combined surgical and oncological) treatment, local- and later on loco-regional recurrence has been detected on follow-up staging, influencing further chemotherapy regime. Taking both the fairly unknown type of the tumor and uncertain response rate to oncological therapy into account, prolonged tumor pace with fairly stable general patient state was reached throughout the course of the disease.
Through surgical tumor resection, and postoperative chemotherapy the patient managed to maintain an acceptable quality of life without major symptoms during ongoing treatment. During our own case, with multiple organ involvement, multivisceral resection, with multimodality treatment had considerable effect in prolonging the lifespan of the patient.
良性前肠囊肿通常在胸部发育，最常见于纵隔。以前也曾发表过涉及各种腹部器官（如肝、胃或胰腺）的罕见病例，这些病例主要发生在后腹膜。
我们在此报告一例前肠囊肿腺癌，累及膈肌左侧、左下肺叶和左肝叶，通过多脏器切除成功切除。在药物假期之间，术后肿瘤治疗已经进行了近 4 年。在化疗方面，尝试了 FOLFOX 4 方案、卡培他滨单药治疗，后来进行了下一代测序，但患者拒绝了后者的治疗方案。尽管采用了多模式（联合手术和肿瘤学）治疗，但在随访分期时发现了局部和随后的局部复发，影响了进一步的化疗方案。考虑到肿瘤类型相当未知，以及对肿瘤治疗的反应率不确定，在整个疾病过程中，肿瘤的进展速度相当缓慢，患者的一般身体状况相当稳定。
通过手术肿瘤切除和术后化疗，患者在持续治疗期间成功维持了可接受的生活质量，没有出现主要症状。在我们自己的病例中，由于多器官受累，多脏器切除和多模式治疗对延长患者的寿命有显著效果。
