摘要
癌肉瘤又称恶性混合性中胚叶肿瘤或恶性混合性苗勒管肿瘤、肉瘤样癌,是一种罕见、侵袭性强、进展快的高度恶性肿瘤,其由恶性上皮成分及肉瘤成分紧密混合而成,其癌组织形态多样,目前尚没有统一、有效的临床治疗方案,预后极差。该文报道了1例卵巢癌肉瘤患者,因右下腹部疼痛1周收入院,在全身麻醉下行剖腹探查术,术中见右侧卵巢有一大小约5 cm×6 cm×3 cm肿物,诊断为右侧卵巢癌,即行全子宫、双侧附件、大网膜、阑尾切除术,双侧输尿管旁病灶切除术,回盲部病灶切除术,小肠系膜转移灶切除术及盆腔及腹主动脉旁淋巴结清扫术。病理回报癌肉瘤,以高级别多形性肉瘤为主、伴有少量低分化癌。术后辅以紫杉醇加卡铂(TC)方案化学治疗,期间患者未严格遵医嘱化学治疗,卵巢癌复发,再次给予TC方案化学治疗,并加用氟尿嘧啶局部病灶化学治疗,患者恢复情况尚可,随访至撰稿日,未发现其他明显异常。该例提示,TC方案联合氟尿嘧啶局部病灶化学治疗可能对卵巢癌肉瘤有效,但其远期效果及是否能广泛应用于临床患者尚需进一步随访及探讨。
Carcinosarcoma,also known as the malignant mixed mesodermal tumor,malignant mixed mullerian tumor or sarcomatoid carcinoma,is a rare,invasive,rapidly progressive and highly malignant tumor.It consists of malignant epithelial and sarcoma substances. It is characterized with cancerous tissues of diverse morphologies. At present,there is no standard and effective clinical therapy for carcinosarcoma and it is of poor clinical prognosis. Herein,we reported one case of ovarian carcinosarcoma. She was admitted to our hospital due to pain in the right lower abdomen for 1 week. She underwent exploratory laparotomy under general anesthesia. Intraoperatively,a mass approximately 5 cm × 6 cm × 3 cm in size was resected in the right ovary,and she was diagnosed with right-sided ovarian cancer. She underwent radical hysterectomy,bilateral adnexectomy,greater omentectomy and appendectomy. The masses surrounding bilateral ureters,ileocecus lesions,masses metastatic to the mesentery of small intestine and pelvic cavity were resected. Abdominal paraaortic lymph node dissection was performed. She was pathologically diagnosed with carcinosarcoma. It mainly consisted of highgrade pleomorphic sarcoma,accompanied by a low quantity of lowly-differentiated carcinoma. Postoperative chemotherapy using paclitaxel combined with carboplatin( TC) was delivered. However,she failed to comply with the chemotherapy and subsequently recurred. She further received TC chemotherapy,supplemented with topical chemotherapy using fluorouracil. Until the submission date,no evident abnormality was reported. The findings prompted that TC chemotherapy in combination with topical chemotherapy using fluorouracil is probably an efficacious treatment of ovarian carcinosarcoma. Nevertheless,the long-term clinical efficacy and its potential of widespread application in clinical practice remain to be elucidated.
出处
《新医学》
2017年第10期749-752,共4页
Journal of New Medicine
基金
吉林省计生委资助项目(2015Z033)
关键词
癌肉瘤
卵巢癌
化学治疗
预后
Carcinosarcoma
Ovarian cancer
Chemotherapy
Prognosis
