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成年男性胚胎性食管横纹肌肉瘤:一例报告及文献复习

Embryonic esophageal rhabdomyosarcoma in an adult male: A case report and literature review.

作者信息

Zhang Xiaoman, Li Guang

机构信息

Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China.

出版信息

Front Oncol. 2022 Sep 2;12:951433. doi: 10.3389/fonc.2022.951433. eCollection 2022.

Abstract

BASIC PRINCIPLE

There exists a rare aggressive neoplasm called esophageal rhabdomyosarcoma. It originates in cells of the striated muscle or mesenchymal cells which differ from the striated muscle. This tumor has a high degree of malignancy and extensive metastasis. Masses of the sick people are at a high phase when going to hospital. Consequently, the prognosis is exceedingly bad.

PATIENT CONCERNS

A 54-year-old male presented with dysphagia as the initial symptom. Gastroscopy showed an irregular protuberant lesion about 18-22 cm from the incisor. The lesion was observed to be pathological under gastroscopy and was diagnosed as an (esophageal) sarcoma.

DIAGNOSIS

Embryonic esophageal rhabdomyosarcoma.

INTERVENTIONS

After receiving two cycles of DP (docetaxel and cisplatin) chemotherapy in the local hospital, the patient received 60 Gy of radiotherapy in 30 fractions combined with chemotherapy at our hospital. Dysphagia was relieved, and the tumor appeared significantly shrunken on imaging after the treatment.

OUTCOMES

Lung metastasis occurred 1 month after radiotherapy, and the patient died of pulmonary edema on March 11, 2022.

LESSONS

Previously reported cases of embryonic esophageal rhabdomyosarcoma are few. Theoretically, the disease should occur in adolescents; nevertheless, our case was a man who was in middle-aged; the neoplasm was in an unusual position: the upper part of the esophagus. Moreover, the patient initially had good response to the combination of radiotherapy and chemotherapy. Although he died 8 months after diagnosis, the presented data represent a valuable resource for understanding the survival benefits of treating embryonic esophageal rhabdomyosarcoma patients with radiotherapy combined with chemotherapy. In addition, we reviewed the previously reported literature, and a total of 17 cases of esophageal rhabdomyosarcoma were identified and analyzed.

摘要

基本原理

存在一种罕见的侵袭性肿瘤,称为食管横纹肌肉瘤。它起源于横纹肌细胞或与横纹肌不同的间充质细胞。这种肿瘤恶性程度高,转移广泛。患者就诊时多处于晚期。因此,预后极差。

患者情况

一名54岁男性以吞咽困难为首发症状。胃镜检查显示距门齿约18 - 22 cm处有一不规则隆起病变。胃镜下观察该病变为病理性,诊断为(食管)肉瘤。

诊断

胚胎型食管横纹肌肉瘤。

干预措施

患者在当地医院接受了两个周期的DP(多西他赛和顺铂)化疗后,在我院接受了30次分割共60 Gy的放疗并联合化疗。吞咽困难得到缓解,治疗后影像学检查显示肿瘤明显缩小。

结果

放疗后1个月发生肺转移,患者于2022年3月11日死于肺水肿。

经验教训

既往报道的胚胎型食管横纹肌肉瘤病例较少。理论上,该病应发生于青少年;然而,我们的病例是一名中年男性;肿瘤位置不寻常:食管上段。此外,患者最初对放化疗联合治疗反应良好。尽管他在诊断后8个月死亡,但所呈现的数据为了解放疗联合化疗治疗胚胎型食管横纹肌肉瘤患者的生存获益提供了宝贵资源。此外,我们回顾了既往报道的文献,共鉴定并分析了17例食管横纹肌肉瘤病例。

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