Lin Y C, Kudelka A P, Tresukosol D, Malpica A, Carrasco C H, Lawrence D D, Collier R E, Munoz A, Delclos L, Kavanagh J J
University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Gynecol Oncol. 1995 Aug;58(2):262-5. doi: 10.1006/gyno.1995.1223.
We report the case of a patient who has a 23-year history of endometrial stromal sarcoma (ESS). She initially underwent tumor-reductive surgery followed by adjuvant radiotherapy. The pelvic tumor recurred nearly 8 years later, obstructing the ureter and directly invading the bladder. It propagated into the vena cava as a thrombus and finally spread into the right heart chambers, leading to cardiac failure 13 years after the recurrence. The patient was treated with hormonal therapy, multiple resections of the pelvic tumor, chemoembolization, and systemic chemotherapy with doxorubicin and cyclophosphamide. She developed recurrent intractable symptoms and was started on prolonged oral etoposide therapy, which stabilized the size of the pelvic tumor and relieved her symptoms for 3 years. Her quality of life has markedly improved without significant morbidity. We review the options for treating recurrent ESS and suggest that use of prolonged oral etoposide therapy warrants further study in this setting.
我们报告了一例患有23年子宫内膜间质肉瘤（ESS）病史的患者。她最初接受了肿瘤减瘤手术，随后进行了辅助放疗。盆腔肿瘤在近8年后复发，阻塞输尿管并直接侵犯膀胱。它以血栓形式蔓延至腔静脉，最终扩散至右心腔，导致复发后13年出现心力衰竭。该患者接受了激素治疗、多次盆腔肿瘤切除术、化疗栓塞以及使用阿霉素和环磷酰胺的全身化疗。她出现了复发性难治性症状，并开始接受长期口服依托泊苷治疗，这使盆腔肿瘤大小稳定，并缓解了她的症状达3年。她的生活质量显著改善，且无明显并发症。我们回顾了复发性ESS的治疗选择，并建议在这种情况下，长期口服依托泊苷治疗的应用值得进一步研究。
