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[李-弗劳梅尼综合征姐妹的多学科治疗报告]

[Report of Multidisciplinary Treatment for Sisters with Li-Fraumeni Syndrome].

作者信息

Suzuki Okihide, Amano Kunihiko, Chika Noriyasu, Yamano Takafumi, Eguchi Hidetaka, Nakashima Hideo, Ooya Soichi, Okazaki Yasushi, Mochiki Erito, Takahashi Takeo, Ishida Hideyuki

机构信息

Dept. of Digestive Tract and General Surgery/Clinical Genetics, Saitama Medical Center, Saitama Medical University.

出版信息

Gan To Kagaku Ryoho. 2022 Dec;49(13):1947-1949.

Abstract

Li-Fraumeni syndrome(LFS)is a hereditary cancer disorder caused by germline variant in TP53 and characterized by various malignancies. Multidisciplinary treatment is needed for tumors of LFS, however, radiation therapy is a relative contraindication because of frequent development of secondary malignancy such as sarcoma in the irradiated field. Case 1: A 22- year-old woman who was diagnosed with LFS by genetic test when she developed upper rectal cancer. Her rectal tumor with marked bilateral lateral lymph node dissection was successfully removed by low anterior resection with extensive lateral lymph node dissection. She underwent resection for ovarian metastasis followed by chemotherapy and radiotherapy but subsequently died by the disease 32 months postoperatively. Case 2(elder sister of Case 1): A brain tumor was identified in the left high frontal lobe to the parietal lobe because of consciousness disorder, after the genetic diagnosis of LFS. The brain tumor was successfully resected. Histological examination revealed diffuse astrocytoma(WHO grade Ⅱ). Local recurrence was observed 46 months later, and radiation therapy was performed. Six months have passed since radiation therapy, no exacerbation of local recurrence has been observed.

摘要

李-佛美尼综合征(LFS)是一种由TP53基因种系变异引起的遗传性癌症疾病,其特征为多种恶性肿瘤。LFS相关肿瘤需要多学科治疗,然而,由于放疗区域频繁发生继发性恶性肿瘤,如肉瘤,放射治疗是相对禁忌的。病例1:一名22岁女性,因患直肠上段癌经基因检测确诊为LFS。她的直肠肿瘤伴双侧明显侧方淋巴结清扫,通过低位前切除术加广泛侧方淋巴结清扫成功切除。她接受了卵巢转移灶切除术,随后进行化疗和放疗,但术后32个月因病死亡。病例2(病例1的姐姐):在LFS基因诊断后,因意识障碍在左侧额顶叶高部位发现脑肿瘤。脑肿瘤成功切除。组织学检查显示为弥漫性星形细胞瘤(世界卫生组织Ⅱ级)。46个月后观察到局部复发,并进行了放射治疗。放疗后已过去6个月,未观察到局部复发加重。

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