子宫血管肉瘤2例报告并文献复习

doi:10.6040/j.issn.1671-7554.0.2022.0099

摘要/Abstract

摘要： 目的分析2例起初被误诊为其他类型子宫恶性肿瘤的子宫血管肉瘤病例并复习相关文献,以提高临床医生对其临床病理特征、治疗和预后的认识。方法收集并分析山东大学齐鲁医院妇科收治的2 例子宫血管肉瘤患者的临床资料,结合相关文献对该疾病进行总结。结果病例1接受了根治性手术,术后给予异环磷酰胺+表柔比星方案化疗6个周期,术后无进展生存期为62个月,总生存期为66个月;病例2接受了根治性手术,术后给予异环磷酰胺+表柔比星方案化疗4个周期,尚无复发迹象。结论子宫血管肉瘤临床上极为罕见,易被误诊,诊断时应借助病理及免疫组化与其他子宫恶性肿瘤相鉴别,手术联合术后辅助化疗可能是子宫血管肉瘤一种有效的治疗方法。

关键词: 血管肉瘤, 子宫恶性肿瘤, 误诊, 治疗, 预后

Abstract: Objective To analyze 2 cases of angiosarcoma of the uterus misdiagnosed as other types of uterine malignancies and to review relevant literature, so as to improve the clinicians awareness of the clinicopathological feature, treatment and prognosis of this disease. Methods The clinical data of 2 cases of uterine angiosarcoma were collected and analyzed, and relevant literature was reviewed. Results Case 1 received radical surgery and 6 cycles of ifosfamide + epirubicin chemotherapy after surgery. The postoperative progression-free survival was 62 months and the overall survival was 66 months. Case 2 received radical surgery and 4 cycles of ifosfamide + epirubicin chemotherapy, with no sign of recurrence. Conclusion Angiosarcoma of the uterus is extremely rare in clinical practice and is easily misdiagnosed. It should be differentiated from other uterine malignancies by pathology and immunohistochemistry. The combination of surgery and adjuvant chemotherapy might be effective.

Key words: Angiosarcoma, Uterine malignancy, Misdiagnosis, Therapy, Prognosis

中图分类号:

R737.33

王丽慧,高敏,孔北华. 子宫血管肉瘤2例报告并文献复习[J]. 山东大学学报 (医学版), 2022, 60(9): 108-112.

WANG Lihui, GAO Min, KONG Beihua. Angiosarcoma of the uterus: a report of 2 cases and literature review[J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 108-112.

参考文献

[1] Young RJ, Brown NJ, Reed MW, et al. Angiosarcoma[J]. Lancet Oncol, 2010, 11(10): 983-991.
[2] Chinczewski L, Taube ET, Feldhaus FW, et al. Angiosarcomas of primary gynecologic origin—a case series and review of the literature[J]. Anticancer Res, 2020, 40(10): 5743-5750.
[3] Hara T, Miyoshi A, Kamei Y, et al. Epithelioid angiosarcoma arising from a huge leiomyoma: a case report and a literature review[J]. Case Rep Obstet Gynecol, 2018, 2018: 7591769. doi: 10.1155/2018/7591769.
[4] Chen TW, Burns J, Jones RL, et al. Optimal clinical management and the molecular biology of angiosarcomas[J]. Cancers(Basel), 2020, 12(11): 3321.
[5] Kruse A, Sep S, Slangen BFM, et al. Angiosarcomas of primary gynecologic origin: a clinicopathologic review and quantitative analysis of survival[J]. Int J Gynecol Cancer, 2014, 24(1): 4-12.
[6] Lahat G, Dhuka AR, Hallevi H, et al. Angiosarcoma: clinical and molecular insights[J]. Ann Surg, 2010, 251(6): 1098-1106.
[7] 熊云棋, 吴霞. 子宫上皮样血管肉瘤1例[J]. 实用妇产科杂志, 2015, 31(12): 938-939.
[8] Cao J, Wang J, He C, et al. Angiosarcoma: a review of diagnosis and current treatment[J]. Am J Cancer Res, 2019, 9(11): 2303-2313.
[9] Merfeld E, Gabani P, Spraker MB, et al. Clinical outcomes and prognostic features of angiosarcoma: significance of prior radiation therapy[J]. Clin Oncol(R Coll Radiol), 2019, 31(4): 232-241.
[10] Olawaiye AB, Morgan JA, Goodman A, et al. Epithelioid angiosarcoma of the uterus: a review of management[J]. Arch Gynecol Obstet, 2008, 278(5): 401-404.
[11] Hwang JP, Lim SM. Uterine epithelioid angiosarcoma on F-18 FDG PET/CT[J]. Nucl Med Mol Imaging, 2013, 47(2): 134-137.
[12] Soydal C, Kucuk ON, Gecim EI, et al. The prognostic value of quantitative parameters of 18F-FDG PET/CT in the evaluation of response to internal radiation therapy with yttrium-90 in patients with liver metastases of colorectal cancer[J]. Nucl Med Commun, 2013, 34(5): 501-506.
[13] 刘梅, 巴恩平, 赵坡, 等. 上皮样血管肉瘤的临床病理分析[J]. 中华病理学杂志, 2002, 31(5): 22-25. LIU Mei, BA Enping, ZHAO Po, et al. A clinicopathological study of fifteen epithelioid angiosarcoma[J]. Chinese Journal of Pathology, 2002, 31(5): 22-25.
[14] Liang D, Li L, He Y, et al. Primary uterine angiosarcoma: a case report in China with the literature review[J]. Indian J Pathol Microbiol, 2020, 63(Supplement): S94-S97.
[15] Sindhu S, Gimber LH, Cranmer L, et al. Angiosarcoma treated successfully with anti-PD-1 therapy—a case report[J]. J Immunother Cancer, 2017, 5(1): 58.
[16] Konishi Y, Sato H, Fujimoto T, et al. A case of primary uterine angiosarcoma: magnetic resonance imaging and computed tomography findings[J]. Int J Gynecol Cancer, 2007, 17(1): 280-284.

相关文章 15

[1]	巩性军，吴树明，张供，李守先，庞昕焱. 无顶冠状静脉窦综合征的诊断和外科治疗[J]. 山东大学学报(医学版), 2209, 47(6): 129-.
[2]	吕艳锋丁克王建新禹化龙贝绍生. 慢性肛瘘癌变诊疗分析[J]. 山东大学学报(医学版), 2209, 47(6): 55-57.
[3]	韩靖,贾春玲. 肺癌患者胸外手术前治疗牙周基础疾病对预防术后肺炎发生的效果评价[J]. 山东大学学报 (医学版), 2022, 60(9): 113-118.
[4]	孙文雄,吴日超,郑贤静,李丽, 张友忠. 宫颈血管周上皮样细胞肿瘤1例[J]. 山东大学学报 (医学版), 2022, 60(9): 125-128.
[5]	郑苏,陈述花,李华,邓劼,陈春红,王晓慧,冯卫星,韩萧迪,张雨佳,李娜,李莫,方方. 脑电变化和BASED评分与54例婴儿痉挛症促肾上腺皮质激素疗效的相关性[J]. 山东大学学报 (医学版), 2022, 60(9): 91-96.
[6]	吴瑞芳,李长忠. 女性生育力保护的现状与进展[J]. 山东大学学报 (医学版), 2022, 60(9): 1-7.
[7]	贺士卿,李皖皖,董书晴,牟婧怡,刘宇莹,魏思雨,刘钊,张家新. 基于数据库构建乳腺癌焦亡相关基因的预后风险模型[J]. 山东大学学报 (医学版), 2022, 60(8): 34-43.
[8]	高中霞,张铭,樊明德,谭晨阳,王梦迪,王超,樊跃飞,丁守銮,王成伟. 伽玛刀治疗81例肺癌脑转移瘤的疗效及预后因素[J]. 山东大学学报 (医学版), 2022, 60(8): 44-49.
[9]	王文静,刘博策,毕见海,霍然. 超声引导下平阳霉素联合聚桂醇硬化治疗94例囊性淋巴管畸形的疗效[J]. 山东大学学报 (医学版), 2022, 60(8): 72-78.
[10]	彭超,周应芳. 子宫腺肌病的药物治疗进展[J]. 山东大学学报 (医学版), 2022, 60(7): 20-25.
[11]	张玉凤,徐敏,邢秀丽,逄曙光,户克庆. 689例非ST段抬高型心肌梗死患者的临床流行病学特征[J]. 山东大学学报 (医学版), 2022, 60(7): 118-122.
[12]	秦静,杨飞,陈谦,夏涵岱,刘延国,王秀问. 晚期驱动基因阴性、PD-L1表达阴性非鳞非小细胞肺癌一线治疗方案的网状Meta分析[J]. 山东大学学报 (医学版), 2022, 60(7): 74-82.
[13]	王福立,孙银萍,秦杰,荣建胜. DC-CIK细胞联合EGFR-TKI治疗35例老年晚期EGFR突变肺癌的效果[J]. 山东大学学报 (医学版), 2022, 60(7): 110-117.
[14]	张景良, 刘新宇, 原所茂, 王连雷. 髋关节疾病合并腰椎退行性疾病(髋腰综合征)误诊误治的原因分析[J]. 山东大学学报 (医学版), 2022, 60(5): 67-73.
[15]	王菊,高帅,范玉琛,王凯. 肝衰竭并发真菌感染综合治疗1例[J]. 山东大学学报 (医学版), 2022, 60(5): 125-128.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed