Recurrent low-grade endometrial stromal sarcoma with intracaval and intracardiac tumor thrombus: diagnosis, treatment, and surgical management
Recurrent low-grade endometrial stromal sarcoma with intracaval and intracardiac tumor thrombus: diagnosis, treatment, and surgical management
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复发性低度子宫内膜间质肉瘤伴腔内和心内癌栓：诊断、治疗和手术治疗
DOI：
10.1007/s13691-013-0134-6
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发表时间：
2014
影响因子：
0.7
通讯作者：
Shiozawa T.
中科院分区：
文献类型：
--
作者：
Miyamoto T;Tachibana R;Kobara H;Takano T;Kato H;Shimizu A;Ohya A;Uehara T;Shiozawa T.
低度恶性子宫内膜间质肉瘤（LG-ESS）约占子宫体恶性肿瘤的1%，生长缓慢，经常表达ER和PR。原发性LG-ESS患者的5年生存率超过90%。然而，大约50%的病例会复发，复发通常发生在10年以上。淋巴管侵犯是经常观察到的，并有几例LG-ESS扩展到主要血管的报告。我们在此报告一例65岁的日本女性在接受初级治疗16年后被诊断为复发性LG-ESS。复发肿瘤位于左卵巢，也位于左肾静脉下方的主动脉旁区域，通过左肾静脉和左腰段静脉延伸到下腔静脉和右心房。我们判断所有肿瘤的初次全切除术是不可能的，并在该病例会议中描述了外科手术，与去除腔内和心内肿瘤血栓相关的风险以及激素治疗。
Low-grade endometrial stromal sarcoma (LG-ESS) accounts for approximately 1 % of malignant tumors in the uterine corpus, grows slowly, and frequently expresses ER and PR. The 5-year survival of patients with primary LG-ESS was shown to be over 90 %. However, approximately 50 % of cases will recur, with recurrence commonly occurring more than 10 years later. Lymph-vascular space invasion is frequently observed, and several cases of LG-ESS with extension into the major vessels have been reported previously. We herein present a case of a 65-year-old Japanese woman diagnosed with recurrent LG-ESS 16 years after receiving primary treatment. Recurrent tumors were located in the left ovary and also in the para-aortic region below the left renal vein, extending into the inferior vena cava and the right atrium through the left renal vein and left lumbar segmental veins. We judged primary total resection of all tumors to be impossible and described the surgical procedure, risks associated with removing intracaval and intracardiac tumor thrombus, and hormone therapy in this case conference.