A case of uterine carcinosarcoma which was strongly suspected to have metastases to the psoas and gluteus muscles
A case of uterine carcinosarcoma which was strongly suspected to have metastases to the psoas and gluteus muscles
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DOI：
10.1007/s13691-018-0333-2
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发表时间：
2018-10-01
影响因子：
0.7
通讯作者：
Shigeta, Hiroyuki
中科院分区：
文献类型：
--
作者：
Ishidera, Yumi;Yoshida, Hiroshi;Shigeta, Hiroyuki
转移到骨骼肌是罕见的。我们报告一个病例，强烈怀疑有腰肌和臀肌转移子宫癌肉瘤。一位68岁女性（孕妇，2;帕拉，0）因子宫癌肉瘤（疑似IB期）接受了腹膜后内镜主动脉旁淋巴结切除术、腹腔镜改良根治性子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结切除术。观察到转移到一个右侧盆腔淋巴结。腹水细胞学检查阴性。术后病理检查显示IIIC 1期（pT 1bN 1 M0）疾病。紫杉醇+卡铂化疗5个周期。化疗后10个月，血清癌抗原-125水平升高。计算机断层扫描（CT）显示左侧腰大肌有一个3厘米的肿瘤，磁共振成像显示左侧臀大肌有一个肿瘤。这些病变在正电子发射断层扫描-CT中显示氟脱氧葡萄糖摄取。由于我们认为肿瘤是子宫癌肉瘤的转移，我们建议她进行化疗。然而，在一个化疗周期后，患者在其他地方接受了免疫检查点抑制剂的免疫治疗。复发后5个月，她还活着。
Metastasis to the skeletal muscles is uncommon. We report a case which was strongly suspected to have psoas and gluteus muscle metastases from uterine carcinosarcoma. A 68-year-old woman (gravida, 2; para, 0) underwent retroperitoneal endoscopic paraaortic lymphadenectomy, laparoscopic modified radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy for uterine carcinosarcoma, suspected to be stage IB. Metastasis to one right pelvic lymph node was observed. Ascites fluid cytology was negative. Postoperative pathological examination revealed stage IIIC1 (pT1bN1M0) disease. Five cycles of chemotherapy with paclitaxel + carboplatin were performed. 10 months after chemotherapy, serum cancer antigen-125 level was elevated. Computed tomography (CT) revealed a 3-cm tumor of the left psoas muscle and magnetic resonance imaging revealed a tumor of the left gluteus maximus muscle. These lesions showed fluorodeoxyglucose uptake in positron emission tomography-CT. Because we considered the tumors were metastases of uterine carcinosarcoma, we recommended her chemotherapy. However, after one cycle of chemotherapy, the patient underwent immunotherapy elsewhere with immune checkpoint inhibitors. 5 months after the recurrence, she was alive.