1例实现R0切除但快速进展伴脑转移的晚期 卵巢未分化肉瘤及其文献复习

A Case of Advanced Undifferentiated Ovarian Sarcoma with Rapid Progression and Brain Metastasis after R0 Resection and Literature Review

摘要: 卵巢未分化肉瘤(Undifferentiated Ovarian Sarcoma, UOS)是一种起源于卵巢间质的高度恶性肿瘤，极为罕见，国内外仅以个案报道出现。其临床表现缺乏特异性，侵袭性强，预后差，早期难以识别，确诊主要依靠病理形态学及免疫组化检查。目前治疗上尚无标准的治疗方案，一般借鉴卵巢上皮性癌(Ovarian cancer, OC)的治疗原则。本文报道1例晚期卵巢未分化肉瘤患者，初次治疗行肿瘤细胞减灭术并达到R0切除，术后补充紫杉醇 + 表柔比星方案6周期化疗，最后因脑转移死亡，总生存期限11个月。现将其诊治过程结合相关文献进行回顾，旨在提高对本病的认识，减少误诊和漏诊。

Abstract: Undifferentiated ovarian sarcoma (UOS) is a highly malignant tumor derived from ovarian stroma. It is extremely rare and has only been reported in sporadic case reports at home and abroad. This disease presents with non-specific clinical manifestations, high invasiveness and poor prognosis, and is difficult to identify at an early stage. The definitive diagnosis mainly relies on pathological morphology and immunohistochemical examination. At present, there is no standardized therapeutic regimen, and the treatment principles for ovarian epithelial carcinoma (OC) are generally adopted for reference. Herein, we report a case of advanced undifferentiated ovarian sarcoma. The patient underwent primary cytoreductive surgery with successful R0 resection, followed by six cycles of adjuvant chemotherapy with paclitaxel plus epirubicin. Eventually, the patient died of brain metastasis, with an overall survival of 11 months. The diagnosis and treatment process of this case were reviewed in combination with relevant literature, aiming to deepen the understanding of this disease and reduce the incidence of misdiagnosis and missed diagnosis.