小肠肉瘤样癌两次手术后伴肝肺转移一例并文献复习  

Sarcomatoid carcinoma of small intestine after two operations with postoperative liver and lung metastases:a case report with a literature review

作　　者：周颖 李杰 许培培 赵滨 付川川 杨琴 芮元祎[1] 张轲 郑阳春 Zhou Ying;Li Jie;Xu Peipei;Zhao Bin;Fu Chuanchuan;Yang Qin;Rui Yuanyi;Zhang Ke;Zheng Yangchun(Ward No.1,Gastrointestinal Surgery Center,Sichuan Cancer Hospital,Sichuan Chengdu 610041,China;Chengdu Medical College,Sichuan Chengdu 610500,China;Fifth Municipal People′s Hospital,Sichuan Chengdu 611130,China;University of Electronic Science&Technology,Sichuan Chengdu 610054,China)

机构地区：[1]四川省肿瘤医院胃肠外科中心一病区,四川成都610041 [2]成都医学院,四川成都610500 [3]成都市第五人民医院,四川成都611130 [4]电子科技大学,四川成都610054

出　　处：《腹部外科》2021年第3期207-210,共4页Journal of Abdominal Surgery

摘　　要：此例病人于2017年4月因腹痛行腹部MRI提示右侧中腹部局部小肠增粗伴肠壁增厚,行腹腔镜下小肠肿块切除术,术后病理提示小肠肉瘤样癌。2017年9月复查腹部增强MRI提示左中上腹部小肠管腔内占位,考虑肿瘤复发,行空肠巨大肿瘤切除术,术后病理及免疫组化再次证实为空肠肉瘤样癌。2018年3月行正电子发射计算机断层显像-CT(PET-CT)检查提示肿瘤局部复发,伴肝、肺转移,未行抗肿瘤治疗,2018年6月病人因肿瘤于当地医院死亡。小肠肉瘤样癌十分罕见,临床表现缺乏特异性,需根据术后病理及免疫组化明确诊断,目前治疗手段主要为根治性手术切除。该肿瘤恶性程度高,侵袭性强,整体预后差,5年生存率几乎为零。In April 2017,the patient received an examination of magnetic resonance imaging(MRI)due to abdominal pain.MRI revealed thickening ofsmall bowel inmiddle/lateral abdomen.Then lesion of small bowel was removed and postoperative pathology hinted at sarcomatoid carcinoma.In September 2017,contrast-enhanced abdominal MRI indicated an intraluminal small bowel mass inleft middle-upper abdomen.And tumor recurrence was suspected.After re-operation,postoperative pathology and immunohistochemistry confirmed a diagnosis of jejunal sarcomatoid carcinoma.In March 2018,PET/CT revealed local recurrence with liver and lung metastasis.No anti-tumor therapy was offered.In June 2018,he died at a local hospital.Intestinal sarcomatoid carcinoma is rareand its clinical manifestations lack specificity.A definite diagnosis is made by postoperative pathological and immunohistochemical examinations.Currently the major treatment is radical resection.With a high level of malignancy and a strong capacity of invasion,it has a poor prognosis.Its five-year survival rate is almost zero.

关 键 词：小肠肉瘤样癌 外科学 治疗 预后 

分 类 号：R735.32[医药卫生—肿瘤]