RESUMEN
Benign metastasising leiomyoma (BML) is a rare disease in which histologically benign uterine fibroids spread throughout the body. It is thought to originate from the hematogenous metastasis of myoma cells following myomectomy. To date, BML has been noted in patients with respiratory symptoms, even during regular checkups. There are few case reports of co-occurrence with gynaecological cancer. We report the case of a suspected stage IVb carcinoma based on preoperative examination for endometrial cancer, that indicated lung metastasis. However, postoperative pathology revealed a grade 1, pT1a pN0 tumour. We suspected BML based on the discrepant findings and history of myomectomy, and this was confirmed by lung biopsy. In metastatic lesions of a carcinoma patient with a history of myomectomy, the co-occurrence of BML should be considered when there is discrepancy between the preoperative suspected stage and postoperative pathology.
Asunto(s)
Neoplasias Endometriales , Leiomioma , Neoplasias Pulmonares , Neoplasias Uterinas , Diagnóstico Diferencial , Neoplasias Endometriales/diagnóstico , Femenino , Humanos , Leiomioma/diagnóstico , Leiomioma/cirugía , Neoplasias Pulmonares/diagnóstico , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirugíaRESUMEN
Malignant peritoneal mesothelioma is extremely rare, and its prognosis is poor. The median survival period is said to be approximately one year after diagnosis. We report a case of recurrent malignant peritoneal mesothelioma treated with concurrent chemoradiotherapy (CCRT). The patient has been alive for six years without recurrence. This report seems to be the first that indicates CCRT to be useful for peritoneal mesothelioma. The patient was a 21-year-old woman who underwent emergency surgery of the in acute abdomen at another hospital. The resected tumor was 18 cm in size and pathological examination revealed that it was a malignant mesothelioma of the epithelioid type. CAP therapy (cyclophosphamide+adriamycine+cisplatin)+CPT-11 administration was given only one course, and the patient was then transferred to our hospital. She underwent resection of the residual disease and six courses of TC therapy (paclitaxel+carboplatin) as adjuvant chemotherapy. Twelve months after chemotherapy, pelvic recurrence occurred. We attempted surgery but only biopsy could be performed because of a pelvic wall invasion. The patient underwent CCRT with weekly cisplatin. The tumor was reduced by irradiation of 50. 4 Gy and disappeared after 6 months. No recurrence has been found six years since the last treatment. CCRT might be effective against malignant peritoneal mesothelioma of the epithelioid type.
Asunto(s)
Quimioradioterapia , Mesotelioma/terapia , Neoplasias Peritoneales/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Femenino , Humanos , Inducción de Remisión , Adulto JovenRESUMEN
INTRODUCTION: Most patients with peripheral arterial occlusion have underlying atherosclerosis. Peripheral arterial thrombosis induced by chemotherapy in gynecological malignancies is rare. CASE REPORT: A 60-year-old woman was diagnosed with ovarian carcinoma coexisting with endometrial carcinoma after surgical histopathological examination. Chemotherapy was started on postoperative day 11. On day 2 of chemotherapy, she developed bilateral lower extremity cyanosis. Thrombocytopenia due to chemotherapy was diagnosed and treated with repeated platelet transfusions. Anticoagulant therapy was also continued. However, the patient worsened steadily and died of liver dysfunction due to multiple liver metastases. CONCLUSION: Although arterial thrombosis induced by chemotherapy is rare, it is important for physicians to consider this possibility in the course of treatment with cytotoxic agents because this complication has serious health implications.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias Endometriales/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Enfermedades Vasculares Periféricas/inducido químicamente , Trombosis/inducido químicamente , Adenocarcinoma/cirugía , Carboplatino/administración & dosificación , Neoplasias Endometriales/cirugía , Resultado Fatal , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/cirugía , Paclitaxel/administración & dosificación , Posmenopausia , Trombocitopenia/inducido químicamente , Trombocitopenia/complicacionesRESUMEN
A 58-year-old woman was diagnosed with endometrial carcinoma. Total hysterectomy, bilateral salpingo-oophorectomy and paraaortic and a pelvic lymph node dissection were performed. The cytology of peritoneal fluid was negative. There was no peritoneal dissemination except umbilical nodule. A peritoneal 2.0x1.5 cm umbilical nodule was also resected. The nodule was identified as a metastasis from endometrial cancer with endometriosis. The pelvic lymph nodes also showed metastatic lesion with endometriosis. Our case showed that endometriosis coexisted with umbilical and pelvic lymph nodal metastatic lesions from endometrial cancer. This fact suggests that the mode of metastasis to the umbilicus via lymph flow from endometrial cancer is the same as that for endometriosis.