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绒癌肠道转移:病例系列及文献复习。

Intestinal metastasis from choriocarcinoma: a case series and literature review.

机构信息

Department of Gynaecology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

World J Surg Oncol. 2022 Jun 1;20(1):173. doi: 10.1186/s12957-022-02623-0.

Abstract

BACKGROUND

Gestational choriocarcinoma is a rare trophoblastic tumor that spreads mainly to the lung, liver, and central nervous system. Fewer than 5% of patients present with metastasis to the gastrointestinal system and have a poor prognosis CASE PRESENTATION: We describe four cases of patients with intestinal metastasis from choriocarcinoma who visited the First Affiliated Hospital of Zhejiang University School of Medicine and the First People's Hospital of Hangzhou between April 2012 and October 2019. Four patients presented with gastrointestinal symptoms or developed gastrointestinal symptoms during treatment for choriocarcinoma. Three patients had these intestinal lesions surgically removed, and the postoperative pathology results suggested choriocarcinoma. All patients received multiple chemotherapy regimens during treatment for suboptimal human chorionic gonadotropin (hCG) levels; one patient died 22 months after a definitive diagnosis was made, and the other three patients are still undergoing regular follow-up.

CONCLUSION

Given the low incidence of intestinal metastases from choriocarcinoma, the metastatic route of intestinal metastases from choriocarcinoma remains to be elucidated, and diagnosis mainly depends on pathology findings. An effective treatment has not been determined, and surgical excision with chemotherapy is generally accepted.

摘要

背景

绒癌是一种罕见的滋养细胞肿瘤,主要向肺部、肝脏和中枢神经系统转移。不到 5%的患者出现胃肠道转移,预后不良。

病例介绍

我们描述了 4 例于 2012 年 4 月至 2019 年 10 月期间在浙江大学医学院附属第一医院和杭州市第一人民医院就诊的绒癌肠转移患者。4 例患者以胃肠道症状就诊,或在绒癌治疗过程中出现胃肠道症状。3 例患者经手术切除肠内病变,术后病理结果提示绒癌。所有患者在 hCG 水平不佳的情况下接受了多次化疗方案治疗;1 例患者在确诊后 22 个月死亡,其余 3 例患者仍在定期随访中。

结论

鉴于绒癌肠转移发生率较低,其转移途径仍不清楚,诊断主要依赖于病理发现。尚未确定有效的治疗方法,一般接受手术切除加化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28d/9158317/dc7652559451/12957_2022_2623_Fig1_HTML.jpg

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