Inoue K, Yamamoto R, Nishiyama N, Hori T, Miyamoto Y, Takehara S, Kaji M, Kin T, Katoh T, Iwata T, Nishida T, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Japan.
Osaka City Med J. 1998 Jun;44(1):125-31.
The patient was a 24-year-old woman. She underwent marginal excision of synovial sarcoma originating in the right femoral soft tissue at the age of 18, followed by local radiation therapy and chemotherapy. At the age of 20, abnormal shadow was indicated in bilateral lungs on plain roentgenography of the chest, and she underwent open-chest surgery for excision of bilateral pulmonary metastatic tumors. She was subjected to bilateral thoracotony repeatedly thereafter for a total of 5 times, and all of the metastatic foci detected in each operation were resected. Consequently, she has been surviving for a long period of about 7 years. The therapeutic outcome of tumor of bone soft tissue is greatly affected by its pulmonary metastasis. Although the therapeutic outcome has recently been improved by large dose chemotherapy and active excision of metastatic foci in the lung, survival time in the case of synovial sarcoma, giant cell sarcoma and Ewing's sarcoma is not very long yet. In the present study, we observed a patient who had lung metastasis of synovial sarcoma of which prognosis is generally considered poor has been surviving for a long time of 7 years owing to active excision of pulmonary metastatic foci. The relation of the present prognostic factors to those in the past were compared.
该患者为一名24岁女性。她在18岁时接受了起源于右股部软组织的滑膜肉瘤边缘切除术，随后接受了局部放疗和化疗。20岁时，胸部X线平片显示双侧肺部有异常阴影，她接受了开胸手术以切除双侧肺转移瘤。此后她又反复接受了5次双侧开胸手术，每次手术中检测到的所有转移灶均被切除。因此，她已经存活了大约7年。骨软组织肿瘤的治疗结果受其肺转移的影响很大。尽管近年来大剂量化疗和积极切除肺部转移灶使治疗结果有所改善，但滑膜肉瘤、巨细胞肉瘤和尤因肉瘤患者的生存时间仍不是很长。在本研究中，我们观察到一名滑膜肉瘤肺转移患者，其预后通常被认为较差，但由于积极切除肺部转移灶，已存活了7年之久。我们比较了目前的预后因素与过去的预后因素之间的关系。
