Miura Hiroyuki, Miura Jun, Goto Shinichi, Yamamoto Tomoko
Department of Thoracic Surgery Akiru Municipal Medical Centre Tokyo Japan.
Department of Surgery Kyorin University School of Medicine Tokyo Japan.
Respirol Case Rep. 2022 Jun 9;10(7):e0988. doi: 10.1002/rcr2.988. eCollection 2022 Jul.
We report a rare case of ovarian carcinoma in which a mediastinal recurrence was resected 16 years after the initial operation. A 72-year-old woman underwent hysterectomy with adnexectomy for stage IIIC ovarian serous carcinoma after neoadjuvant chemotherapy. Six courses of adjuvant chemotherapy were administered. Three years after surgery, left supraclavicular lymph node metastasis occurred, and radiotherapy and two courses of chemotherapy were administered. Six years before presentation, a metastasis at the right cardiophrenic lymph node was resected, and six courses of chemotherapy were administered. During follow-up, a retrosternal tumour was found. The metastatic lesion in contact with the diaphragm was thought to result from pleuroperitoneal communication, and it increased in size. Although high-grade serous carcinoma is aggressive, its sensitivity to chemotherapy may suppress early recurrence, contributing to good outcomes, but with late recurrence. Multidisciplinary therapy including surgery is required for improved long-term prognosis for mediastinal metastasis of ovarian serous carcinoma.
我们报告了一例罕见的卵巢癌病例,该患者在初次手术后16年纵隔复发并接受了切除术。一名72岁女性在新辅助化疗后因IIIC期卵巢浆液性癌接受了子宫切除术及附件切除术。术后进行了六个疗程的辅助化疗。术后三年,出现左锁骨上淋巴结转移,接受了放疗及两个疗程的化疗。就诊前六年,右心膈角淋巴结转移灶被切除,并进行了六个疗程的化疗。随访期间,发现胸骨后肿瘤。与膈肌接触的转移灶被认为是由胸膜腹膜交通引起的,且其大小增大。虽然高级别浆液性癌侵袭性强,但其对化疗的敏感性可能会抑制早期复发,从而带来较好的预后,但会出现晚期复发。对于卵巢浆液性癌纵隔转移,需要包括手术在内的多学科治疗以改善长期预后。