Rhomberg W, Gruber-Mösenbacher U, Eiter H, Fritzsche H, Breitfellner G
Abteilung Radioonkologie, Landeskrankenhaus, Feldkirch, Osterreich.
Schweiz Med Wochenschr. 1993 Sep 4;123(35):1640-4.
Five new cases of malignant hemangioendothelioma of the thyroid are reported. This rare malignant tumor is described predominantly in regions with endemic goiter such as the Alpine zone. The estimated incidence of the disease is between 0.15 and 0.25 per 100,000 inhabitants per year for Western Austria. Two of the five patients were heavily exposed to vinyl chloride occupationally for 9 and 30 years respectively. Surgically, a R-0 resection was performed in two patients, R-1 in two, and R-2 in one patient. Postoperative radiotherapy was given in four cases. The tumor doses were between 58 and 65 Gy. Three patients received the sensitizer razoxane in addition. Local tumor control was achieved in 4 of 5 patients. The survival times of the 5 patients were 78, 68+, 38+, 7.5 and 3 months. Two patients are still alive after 68 and 38 months. This small series may indicate that the outcome of the disease may not be uniformly deleterious and the resistance to radiotherapy reported in the literature [3, 10] is debatable.
报告了5例甲状腺恶性血管内皮瘤新病例。这种罕见的恶性肿瘤主要见于地方性甲状腺肿流行地区,如阿尔卑斯地区。奥地利西部该病的估计发病率为每年每10万居民0.15至0.25例。5例患者中有2例分别在职业上大量接触氯乙烯达9年和30年。手术方面,2例患者进行了R-0切除,2例进行了R-1切除,1例进行了R-2切除。4例患者术后接受了放疗。肿瘤剂量在58至65 Gy之间。3例患者还接受了增敏剂丙亚胺。5例患者中有4例实现了局部肿瘤控制。5例患者的生存时间分别为78个月、68个月以上、38个月以上、7.5个月和3个月。2例患者在68个月和38个月后仍然存活。这个小系列病例可能表明,该病的预后并非一律不良,文献[3,10]中报道的对放疗的抗性值得商榷。