Aly Mohamed, Shahhat Shaheer, Nguyen Timothy K
Schulich School of Medicine and Dentistry, Western University, London, CAN.
Radiation Oncology, London Health Sciences Centre, London, CAN.
Cureus. 2024 Aug 26;16(8):e67835. doi: 10.7759/cureus.67835. eCollection 2024 Aug.
Stereotactic body radiotherapy (SBRT) is a non-invasive form of radiation that has been utilized for oligometastatic malignancies. However, pseudoprogression is a common radiological occurrence following this treatment, which manifests as an increase in tumor size before its reduction. We discuss a case of a 58-year-old female patient who initially presented with uterine leiomyosarcoma. Following surgery and postoperative radiation, she was later found to have solitary liver metastasis after three years of surveillance, which was managed by SBRT. However, on short-term follow-up, the lesion was found to have increased in size, prompting discussion regarding whether the growth was a progression of disease or a secondary effect of treatment. After close follow-up, the tumor continued to shrink until it was no longer visible on imaging. This is the first report discussing pseudoprogression following SBRT in a retroperitoneal leiomyosarcoma patient. It serves as a reminder for clinicians to consider the possibility of pseudoprogression before the failure of therapy.
立体定向体部放疗（SBRT）是一种用于寡转移恶性肿瘤的非侵入性放疗形式。然而，假进展是这种治疗后常见的影像学表现，表现为肿瘤在缩小之前体积增大。我们讨论一例58岁女性患者，她最初被诊断为子宫平滑肌肉瘤。手术及术后放疗后，经过三年的随访，她后来被发现有孤立性肝转移，采用SBRT治疗。然而，在短期随访中，发现病灶体积增大，引发了关于这种增大是疾病进展还是治疗的继发效应的讨论。经过密切随访，肿瘤持续缩小直至影像学上不再可见。这是首例讨论腹膜后平滑肌肉瘤患者接受SBRT治疗后出现假进展的报告。它提醒临床医生在治疗失败前要考虑假进展的可能性。
