同期双原发胃癌合并肾平滑肌肉瘤:1例报告  

Simultaneous double primary gastric cancer with renal leiomyosarcoma:a case report

作　　者：刘腾飞[1] 林晓琳[1] 韩婷[1] 卓萌[1] 刘泽兵 肖秀英[1] LIU Tengfei;LIN Xiaolin;HAN Ting;ZHUO Meng;LIU Zebing;XIAO Xiuying(Department of Oncology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Pathology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院肿瘤科,上海200127 [2]上海交通大学医学院附属仁济医院病理科,上海200127

出　　处：《肿瘤》2022年第12期825-829,共5页Tumor

摘　　要：目的:报道1例罕见的胃癌合并肾平滑肌肉瘤病例,探讨其临床特点及诊治方法,以提高对独立多部位原发恶性肿瘤的认识。方法:通过对1例胃癌合并肾平滑肌肉瘤的同时性双原发肿瘤患者的诊治过程分析,结合国内外相关文献报道,总结该类患者的临床诊治经验。结果:本例胃癌合并肾平滑肌肉瘤患者在体检时发现右肾占位,外科手术切除后病理诊断为右肾平滑肌肉瘤。术后胃镜活检确诊为胃窦腺癌。化疗3个周期后行胃肿瘤手术切除。术后发现颈部淋巴结和肺转移,穿刺病理诊断为平滑肌肉瘤转移。经化疗、放疗和靶向治疗后,患者病情稳定,生存期已超过3年。结论:同时性双原发胃癌和肾平滑肌肉瘤极为罕见,诊断需排除原发肿瘤转移可能。本例患者在肾平滑肌肉瘤术后随访期间确诊原发胃窦腺癌。左侧颈部淋巴结为胃癌常见转移部位,而该例患者病理确诊为肾平滑肌肉瘤转移。虽处于肿瘤晚期,经多学科协作综合治疗,在保证患者较好的生活质量的同时,延长了生存期。Objective:To improve the understanding of independent multi-primary malignant tumors,a rare case of gastric cancer with renal leiomyosarcoma is reported to explore its clinical features,diagnosis and treatment.Methods:The clinical diagnosis and treatment experience of the patient was summarized by analyzing the diagnosis and treatment process of simultaneously double primary tumor—gastric cancer complicated with renal leiomyosarcoma and the relevant literatures were reviewed.Results:The right kidney tumor was found during physical examination.After surgical resection,the pathology showed leiomyosarcoma of the right kidney.Gastric adenocarcinoma was confirmed by gastroscopic biopsy after postoperative follow,and gastric tumor was surgically removed after 3 cycles of chemotherapy.Cervical lymph node and lung metastases were found after surgery,and further biopsy was confirmed as leiomyosarcoma metastasis.After comprehensive treatment including chemotherapy,radiotherapy and targeted therapy,the patient is stable at present,and the survival period has exceeded three years.Conclusion:Simultaneously double primary gastric cancer complicated with renal leiomyosarcoma is extremely rare,and the possibility of primary tumor metastasis should be excluded in diagnosis.In this report,primary gastric adenocarcinoma was diagnosed during postoperative follow-up for renal sarcoma,and left cervical lymph node is a common metastatic site of gastric cancer,while the patient was pathologically confirmed as sarcoma metastasis.Although the patient is in advanced stage,the multi-disciplinary collaborative comprehensive treatment may ensure better quality of life and prolong the survival of the patients.

关 键 词：胃癌 肾平滑肌肉瘤 双原发恶性肿瘤 治疗 

分 类 号：R737.11[医药卫生—肿瘤] R735.2[医药卫生—临床医学]