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Bulky malignant peripheral nerve sheath tumour of the left thigh in a pregnant woman presenting with a pathological fracture of the proximal femur.孕妇左大腿巨大恶性外周神经鞘瘤,表现为股骨近端病理性骨折。
BMJ Case Rep. 2024 Apr 3;17(4):e253070. doi: 10.1136/bcr-2022-253070.
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本文引用的文献

1
Fungating malignant peripheral nerve sheath tumor arising from a slow-growing mass in the forearm: a case report and review of the literature.前臂缓慢生长肿块处发生的外生性恶性外周神经鞘瘤:病例报告及文献复习。
J Med Case Rep. 2020 Jul 7;14(1):91. doi: 10.1186/s13256-020-02427-4.
2
Malignant Peripheral Nerve Sheath Tumors: From Epigenome to Bedside.恶性外周神经鞘瘤:从表观基因组学到临床。
Mol Cancer Res. 2019 Jul;17(7):1417-1428. doi: 10.1158/1541-7786.MCR-19-0147. Epub 2019 Apr 25.
3
Enlarging Plexiform Tumor in a Pregnant Patient with Neurofibromatosis Type One.一名患有1型神经纤维瘤病的孕妇体内的丛状肿瘤增大
Cureus. 2018 Jun 13;10(6):e2802. doi: 10.7759/cureus.2802.
4
Immunohistochemical evaluation of H3K27 trimethylation in malignant peripheral nerve sheath tumors.恶性外周神经鞘瘤中H3K27三甲基化的免疫组织化学评估
Pathol Res Pract. 2018 Mar;214(3):417-425. doi: 10.1016/j.prp.2017.12.015. Epub 2018 Jan 31.
5
Biology and Management of Undifferentiated Pleomorphic Sarcoma, Myxofibrosarcoma, and Malignant Peripheral Nerve Sheath Tumors: State of the Art and Perspectives.未分化多形性肉瘤、黏液纤维肉瘤和恶性外周神经鞘瘤的生物学特性和治疗管理:现状与展望。
J Clin Oncol. 2018 Jan 10;36(2):160-167. doi: 10.1200/JCO.2017.75.3467. Epub 2017 Dec 8.
6
SARC006: Phase II Trial of Chemotherapy in Sporadic and Neurofibromatosis Type 1 Associated Chemotherapy-Naive Malignant Peripheral Nerve Sheath Tumors.SARC006:散发性及1型神经纤维瘤病相关初治恶性周围神经鞘膜瘤化疗的II期试验
Sarcoma. 2017;2017:8685638. doi: 10.1155/2017/8685638. Epub 2017 Sep 12.
7
Loss of H3K27 tri-methylation is a diagnostic marker for malignant peripheral nerve sheath tumors and an indicator for an inferior survival.H3K27三甲基化缺失是恶性外周神经鞘瘤的诊断标志物及预后较差的指标。
Mod Pathol. 2016 Jun;29(6):582-90. doi: 10.1038/modpathol.2016.45. Epub 2016 Mar 18.
8
PRC2 loss amplifies Ras-driven transcription and confers sensitivity to BRD4-based therapies.PRC2 缺失会增强 Ras 驱动的转录,并赋予对基于 BRD4 的治疗的敏感性。
Nature. 2014 Oct 9;514(7521):247-51. doi: 10.1038/nature13561. Epub 2014 Aug 13.
9
Neurofibromin specific antibody differentiates malignant peripheral nerve sheath tumors (MPNST) from other spindle cell neoplasms.神经纤维瘤特异性抗体可区分恶性外周神经鞘瘤 (MPNST) 与其他梭形细胞肿瘤。
Acta Neuropathol. 2014 Apr;127(4):565-72. doi: 10.1007/s00401-014-1246-6. Epub 2014 Jan 25.
10
Sox10 and S100 in the diagnosis of soft-tissue neoplasms.Sox10和S100在软组织肿瘤诊断中的应用
Appl Immunohistochem Mol Morphol. 2012 Oct;20(5):445-50. doi: 10.1097/PAI.0b013e318244ff4b.

孕妇左大腿巨大恶性外周神经鞘瘤,表现为股骨近端病理性骨折。

Bulky malignant peripheral nerve sheath tumour of the left thigh in a pregnant woman presenting with a pathological fracture of the proximal femur.

机构信息

Department of Orthopedic Surgery, Centro Hospitalar Universitario de Santo António, Porto, Portugal.

School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal.

出版信息

BMJ Case Rep. 2024 Apr 3;17(4):e253070. doi: 10.1136/bcr-2022-253070.

DOI:10.1136/bcr-2022-253070
PMID:38569727
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11002337/
Abstract

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.

摘要

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。