Department of Orthopedic Surgery, Centro Hospitalar Universitario de Santo António, Porto, Portugal.
School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal.
BMJ Case Rep. 2024 Apr 3;17(4):e253070. doi: 10.1136/bcr-2022-253070.
Malignant peripheral nerve sheath tumour (MPNST) is an aggressive soft tissue sarcoma with a poor prognosis, affecting most commonly the extremities. The lungs constitute the most frequent location for distant metastases. Half of all MPNSTs arise in patients with neurofibromatosis type 1, while approximately 10% are radiation induced and the rest are sporadic.The authors present a pregnant woman in her 40s with a sporadic MPNST of the lower limb and with lung metastases at diagnosis. Treatment consisted of interilioabdominal amputation, followed by adjuvant chemotherapy. Partial response and disease stabilisation were achieved with chemotherapy.Surgical resection with negative margins is the only potentially curative therapy, while radiation therapy and chemotherapy might be useful in the neoadjuvant or adjuvant setting, but their advantage in survival is not demonstrated. In the reported case, chemotherapy permitted the achievement of partial response and stabilisation of the disease.
恶性外周神经鞘瘤(MPNST)是一种侵袭性软组织肉瘤,预后不良,最常影响四肢。肺部是远处转移的最常见部位。一半的 MPNST 发生在神经纤维瘤病 1 型患者中,约 10%是放射性诱导的,其余是散发性的。作者报告了一名 40 多岁的孕妇,患有下肢散发性 MPNST 和诊断时的肺部转移。治疗包括腹会阴联合切除术,然后辅助化疗。化疗取得部分缓解和疾病稳定。手术切除并切缘阴性是唯一可能治愈的治疗方法,而放疗和化疗在新辅助或辅助治疗中可能有用,但在生存方面的优势尚未得到证实。在报告的病例中,化疗使疾病达到部分缓解和稳定。