Uchida T, Nakakawaji K, Sakamoto J, Kojima H, Murakami H, Kato J, Yasue M
Department of Surgery, Aichi Prefectural Hospital, Kakemachi, Okazaki, Japan.
Surg Today. 1996;26(2):138-41. doi: 10.1007/BF00311780.
A 51-year-old woman was admitted to our hospital for further investigation of chest X-ray films which showed multiple shadows that had been growing slowly over 2 years. Her only symptom was hemosputa. The lesions were suspected of being metastasizing leiomyoma due to her past history of uterine leiomyoma. Just 1 week before undergoing scheduled open lung biopsy, the lung lesions increased remarkably in size and number. A thoracotomy was performed and six of the numerous nodules were removed. The resected specimens were pathologically diagnosed as metastasizing leimyosarcoma which was positive for the progesterone and estrogen receptors. Thus, 1 month postoperatively, a course of medroxyprogesterone (MPA), 600 mg daily, was commenced. The residual lesions in her chest started to diminish, shortly afterward. She has remained well on this MPA regimen for 45 months. The prognosis of patients with metastasizing leiomyosarcoma is poor because of its low sensitivity to chemotherapy; however, some types of leiomyosarcoma are hormone-sensitive. It is therefore important to examine the hormone receptors of excised tumors from patients suspected of having metastasizing leiomyoma or leimyosarcoma.
一名51岁女性因胸部X光片显示有多个阴影且在两年内缓慢增大而入院接受进一步检查。她唯一的症状是咯血。由于她既往有子宫平滑肌瘤病史，这些病变怀疑是转移性平滑肌瘤。就在预定进行开胸肺活检前1周，肺部病变的大小和数量显著增加。于是进行了开胸手术，切除了众多结节中的6个。切除标本经病理诊断为转移性平滑肌肉瘤，孕激素和雌激素受体呈阳性。因此，术后1个月开始每天服用600毫克甲羟孕酮（MPA）。此后不久，她胸部的残留病变开始缩小。她按此MPA治疗方案已健康维持了45个月。转移性平滑肌肉瘤患者的预后较差，因为其对化疗敏感性低；然而，某些类型的平滑肌肉瘤对激素敏感。因此，对于怀疑患有转移性平滑肌瘤或平滑肌肉瘤的患者，检查切除肿瘤的激素受体很重要。
