原发性卵巢平滑肌肉瘤1例并文献复习

A Case Report on Primary Ovarian Leiomyo-Sarcoma and Some Related Documents Review

摘要: 患者，女性，55岁，于2010年9月在当地医院体检时彩超发现右卵巢占位，行“右侧卵巢切除术”。术后病理：(右卵巢)镜下见肿瘤细胞呈梭形，可见核分裂。病理诊断：卵巢平滑肌肉瘤。术后无化放疗。至2013年2月因右上腹痛求诊我院，查全身PET-CT提示全身多处软组织、内脏实质(包括肝、肾上腺等)、骨骼转移(metastasis，MT)。进一步行肝占位穿刺活检病理报告提示符合平滑肌肉瘤。遂行CAP 3周方案全身姑息一线化疗2个周期，按RECIST标准((Response evaluation criteria in solid tumors)评估病情为进展，之后改为GP 3周方案全身姑息二线化疗2个周期，按RECIST标准评估病情为稳定(缩小趋势)。至写稿时间患者完成第3周期全身姑息二线化疗，按RECIST标准评估病情仍为稳定。 A 55-year-old woman received a health screening and ultrasound examination revealed a mass of the right ovary on September, 2010. The patient underwent a “right oophorectomy” on the local hospital. Histopathological ex- amination of the right ovary showed that the tumor was composed of dysplasia spindle cells, and mitosis can easily be seen, then a diagnosis of Primary Ovarian Leiomyo-Sarcoma was made. There was neither chemotherapy nor radio-therapy for her after the surgery. The patient consulted in our hospital for suffering from her right upper abdominal pain on February, 2013. The whole-body PET-CT examination revealed that multiple metastasis lesions were found in pare- nchymal of liver and adrenal, bones and systemic soft tissues. Further a fine-needle biopsy of the liver was performed. Pathological diagnosis demonstrated a metastasis of leiomyosarcoma. Thus 2 cycles of the “CAP” 3-week chemother- apy were carried out as the first-line systemic palliative chemotherapy. After that the patient’s status was assessed as progressing with PD, according to the standard of “Response evaluation criteria in solid tumors” (RECIST). Then 2 cycles of “GP” 3-week chemotherapy were schemed as the second-line systemic palliative chemotherapy. After that the tumor was shrinked, and evaluated as stable with SD. To date, the patient has received the third period of systemic pal- liative second-line chemotherapy. And according to the standard of RECIST, the tumor was evaluated as stable again.