High-Grade Leiomyosarcoma Arising in a Previously Replanted Limb.
High-Grade Leiomyosarcoma Arising in a Previously Replanted Limb.
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先前再植肢体中出现的高级别平滑肌肉瘤。
DOI：
10.1155/2015/172603
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发表时间：
2015
影响因子：
0.9
通讯作者：
Weiss,KurtR
中科院分区：
文献类型：
--
作者：
Pan,TiffanyJ;Pantanowitz,Liron;Weiss,KurtR
肉瘤的发展与遗传、辐射、病毒感染和免疫缺陷有关。先前外伤（如烧伤疤痕或骨折部位）出现肉瘤的报道很少。我们报告了一例手臂出现平滑肌肉瘤的病例，该患者八岁时因外伤截肢而在肘关节水平上重新种植了平滑肌肉瘤。二十四年后，他在位于前臂掌侧的再植手臂上发现了一个 10.8 厘米的肿块。肿瘤被完全切除，病理检查显示为高级别筋膜下梭形细胞肉瘤，诊断为 3 级平滑肌肉瘤，分期为 pT2bNxMx。患者接受了近距离放射治疗、游离皮瓣重建以及随后的化疗。据我们所知，这是首例在再植肢体中发生平滑肌肉瘤的病例报告。在这种情况下，平滑肌肉瘤的发展可能与血运重建、疤痕形成或再植后的慢性损伤有关。三年随访后，患者保持健康，没有复发迹象。
Sarcoma development has been associated with genetics, irradiation, viral infections, and immunodeficiency. Reports of sarcomas arising in the setting of prior trauma, as in burn scars or fracture sites, are rare. We report a case of a leiomyosarcoma arising in an arm that had previously been replanted at the level of the elbow joint following traumatic amputation when the patient was eight years old. He presented twenty‐four years later with a 10.8 cm mass in the replanted arm located on the volar forearm. The tumor was completely resected and pathology examination showed a high‐grade, subfascial spindle cell sarcoma diagnosed as a grade 3 leiomyosarcoma with stage pT2bNxMx. The patient underwent treatment with brachytherapy, reconstruction with a free flap, and subsequently chemotherapy. To the best of our knowledge, this is the first case report of leiomyosarcoma developing in a replanted extremity. Development of leiomyosarcoma in this case could be related to revascularization, scar formation, or chronic injury after replantation. The patient remains healthy without signs of recurrence at three‐year follow‐up.