Corrente R F
Am J Surg. 1980 Feb;139(2):265-7. doi: 10.1016/0002-9610(80)90270-6.
The case presented herein has two exciting aspects. First, the cystadenocarcinoma may have developed in a previously existing pseudocyst secondary to trauma 4 years earlier. The history of trauma certainly pointed the author to a diagnosis of pseudocyst. The possibility has to be entertained that a long dormant pseudocyst underwent cystadenomatous and, ultimately, cystadenocarcinomatous change. The acute nature of the patient's clinical problem seems explainable on the basis of recent hemorrhage. The second point is more gratifying. The identification of omental spread at the time of the first operation led to a second and ultimately a third look in this young patient, with a fortunate result. It is only fair to restate the concept that the results in the treatment of malignant disease are more strongly influenced by the "biologic predeterminism" of the tumor than by any of our surgical manipulations [18]. Nonetheless, an aggressive approach to resectable disease in young patients appears justified.
本文所呈现的病例有两个令人关注的方面。其一，囊腺癌可能是在4年前因外伤继发的原有假性囊肿基础上发展而来。外伤史无疑让作者考虑到假性囊肿的诊断。必须考虑到一种可能性，即长期处于静止状态的假性囊肿发生了囊腺瘤样改变，最终发展为囊腺癌。患者临床问题的急性性质似乎可以基于近期出血来解释。第二点更令人欣慰。首次手术时发现网膜转移，促使对这位年轻患者进行了二次乃至三次探查，结果幸运。有必要重申这一观点，即恶性疾病治疗的结果更多地受肿瘤的“生物学预定性”影响，而非我们的任何手术操作[18]。尽管如此，对年轻患者中可切除疾病采取积极的治疗方法似乎是合理的。
