篇名 | UNUSUAL OLIGOMETASTASES OF DISTANT NODES AS THE INITIAL RELAPSE SITE OF UTERINE SARCOMA: A CASE REPORT |
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卷期 | 20:4 |
並列篇名 | 子宮肉瘤不尋常的遠端寡轉移:案例報告 |
作者 | 熊佩韋 、 何懷德 、 魏銘洲 、 蔡建誠 、 謝忱希 |
頁次 | 315-321 |
關鍵字 | 子宮肉瘤 、 導航螺旋刀 、 影像導航放射技術 、 鎖骨上窩轉移 、 Endometrial stromal sarcoma 、 Helical tomotherapy 、 Image-guided radiotherapy 、 Supraclavicular metastases 、 TSCI |
出刊日期 | 201312 |
“未分化”子宮肉瘤,“高悪性度”子宮内膜基質肉瘤(ESS),是種少見且預後不佳的悪性腫瘤。一位48歲女性在本院診斷為“未分化”子宮肉瘤,經過手術與輔助性骨盆腔放射線照射後,在第五個月與第九個月分別發生左側鎖骨上窩與左側腋下淋巴結轉移。左側鎖骨上窩之淋巴結給與根除性放射治療。而左側腋下淋巴結則施以淋巴結摘除術並追加放射線治療。患者治療至今已達五年,目前仍無癌症而存活。左側鎖骨上窩暨腋下淋巴轉移對“未分化”子宮肉瘤乃為罕見案例,縱使病人發生遠端寡轉移,此類患者,若經積極放射線治療仍能有效延長病患存活時間。
“Undifferentiated” uterine sarcoma, or “high-grade” endometrial stromal sarcoma (ESS), is a rare neoplasm characterized by early visceral organ dissemination and poor prognosis. We present a case of a 48-year-old woman with “undifferentiated” uterine sarcoma. She was treated and staged by surgery with adjuvant pelvic irradiation. Metastases of left supraclavicular fossa (SCF) and axillary nodes developed 5 and 9 months after the surgery. Salvage radiotherapy alone was delivered to left SCF region. Furthermore, axillary nodal dissection followed by local radiotherapy was done for left axillary lymphadenopathies. She is alive without evidence of disease and doing well 64 months after the diagnosis of uterine sarcoma. In conclusion, isolated SCF and axillary lymph node metastases are unusual sites of relapse for “undifferentiated” uterine sarcoma. Aggressive radiotherapy with or without surgery may achieve longer survival for such patients with oligometastases of distant nodes.