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青少年 1 型神经纤维瘤病宫颈恶性外周神经鞘瘤:病例报告及文献复习。

Malignant peripheral nerve sheath tumor of the cervix in an adolescent with neurofibromatosis type 1: A case report and review of literature.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.

Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

出版信息

J Obstet Gynaecol Res. 2024 Dec;50(12):2372-2376. doi: 10.1111/jog.16139. Epub 2024 Nov 5.

Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) of the cervix are rare, particularly in patients with neurofibromatosis type 1 (NF1). This report describes a cervical MPNST in an 18-year-old patient with no history of sexual activity, abnormal vaginal discharge, and prolonged menstruation. She had more than six café-au-lait spots on her body since birth and was diagnosed with NF1 at 2 years of age. Positron emission tomography-computed tomography revealed a large pelvic mass and lung and bone metastases. Biopsy confirmed MPNST. Immunohistochemical staining showed diffuse positivity for CD10, approximately 30% positivity for cyclin D1, partial positivity for α-SMA, desmin, and MyoD1, and negativity for myogenin, S-100, and SOX-10. A cancer gene panel identified several genetic abnormalities, but none were actionable mutations. Despite systemic chemotherapy, the tumor progressed rapidly, and the patient died 8 weeks post-admission. Early diagnosis of MPNST is crucial. In patients with NF1, even mild symptoms can indicate MPNST.

摘要

宫颈恶性外周神经鞘瘤(MPNST)较为罕见,尤其在 1 型神经纤维瘤病(NF1)患者中更为少见。本报告描述了一位 18 岁患者的宫颈 MPNST 病例,该患者无性生活史、无异常阴道分泌物、经期延长。她出生时身上就有超过 6 处咖啡牛奶斑,2 岁时被诊断为 NF1。正电子发射断层扫描-计算机断层扫描显示盆腔内有一个大肿块,肺部和骨骼有转移。活检证实为 MPNST。免疫组化染色显示 CD10 弥漫阳性,cyclin D1 约 30%阳性,α-SMA、结蛋白和 MyoD1 部分阳性,肌球蛋白、S-100 和 SOX-10 阴性。癌症基因panel 检测到几种基因异常,但均非可用药突变。尽管进行了全身化疗,肿瘤仍迅速进展,患者入院后 8 周死亡。早期诊断 MPNST 至关重要。在 NF1 患者中,即使是轻微的症状也可能提示 MPNST。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e938/11608839/943c66a3d83b/JOG-50-2372-g002.jpg

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