Isobe H, Wada Y, Ryo J, Matsushita T, Makino T, Satoh B, Kanaya S, Katayama T, Ohtoshi M
Department of Surgery, Himeji National Hospital, Hyogo, Japan.
Surg Today. 1997;27(5):463-5. doi: 10.1007/BF02385715.
Retroperitoneal fibrosarcoma is a rare disease that has proven difficult to treat due to its high incidence of postoperative local recurrence. We recently experienced a patient in whom retroperitoneal fibrosarcoma was followed by liver metastasis without local recurrence. A 34-year-old woman who initially presented with right upper quadrant pain was found to have a retroperitoneal tumor by diagnostic imaging techniques. Extirpation of the tumor was performed and the histopathological diagnosis was fibrosarcoma. A solitary metastasis was detected in the lateral segment 1 year after this operation and a lateral segmentectomy was carried out; however, a short time later, multiple liver metastases were found. Initially, ethanol injections were given with little effect, following which CYVADIC chemotherapy, consisting of cyclophosphamide, vincristine, farmorubicin, and dacarbazine was administered. An excellent responsiveness without severe toxicity was achieved after five cycles, with a significant reduction in tumor size, being estimated as a complete response. Thus, we consider that this chemotherapy regimen could be a promising mode of treatment for liver metastasis from retroperitoneal fibrosarcoma without local recurrence.
腹膜后纤维肉瘤是一种罕见疾病,因其术后局部复发率高,已被证明难以治疗。我们最近遇到一名患者,其腹膜后纤维肉瘤出现肝转移但无局部复发。一名34岁女性最初表现为右上腹疼痛,经诊断成像技术发现有腹膜后肿瘤。进行了肿瘤切除,组织病理学诊断为纤维肉瘤。术后1年在肝外侧段检测到孤立转移灶,并进行了外侧段切除术;然而,不久后发现了多发肝转移。最初给予乙醇注射,效果不佳,随后给予由环磷酰胺、长春新碱、表柔比星和达卡巴嗪组成的CYVADIC化疗。五个周期后取得了良好的反应且无严重毒性,肿瘤大小显著缩小,估计为完全缓解。因此,我们认为这种化疗方案可能是治疗无局部复发的腹膜后纤维肉瘤肝转移的一种有前景的治疗方式。