A CASE REPORT OF GASTRIC CARCINOSARCOMA WITH RHABDOMYOSARCOMATOUS DIFFERENTIATION
作者： Hiroshi OMORI , Hideyuki ONUMA , Yoshinori NIO , Yoshitoshi SATO , Kenji TAKUBO
DOI: 10.3919/JJSA.68.76
关键词: Medicine 、 Pathology 、 Carcinosarcoma 、 Rhabdomyosarcomatous Differentiation
摘要: 症例は62歳, 男性. 2004年6月検診の胃透視で異常を指摘, 胃内視鏡にて胃体中部に2型腫瘍を認め, 低分化腺癌の診断で10月幽門保存胃切除を行った. 術直後の病理診断も同様であり, 補助療法としてTS-1 100mg/日を開始したが, 術後2カ月目に横紋筋肉腫への分化傾向を伴う胃癌肉腫に診断が訂正された. 術後2.5カ月目に, 多発性肝転移と腫瘍からの腹腔内出血を認めたため動脈塞栓療法に続いてドセタキセル60mg/body DIVとサイクロフォスファミド50mg/日の内服による化学療法を開始, その後エプルビシン30mg/body DIVを追加した. 化学療法によって一時的には腫瘍マーカーとしてのCK-MB値に反応がみられたが, CT画像ではほとんど効果はなく, 手術より7カ月目に永眠された. 胃癌肉腫は非常に稀な疾患であり, 悪性度の高い疾患である. 術後の迅速な病理診断はもとより, 症例の蓄積によって有効な化学療法を検索することが急務である.
sci-hub.st 参考文章(8)
P E Hickman, S Messina, J M Trotter, J R Masarei, High creatine kinase MB isoenzyme activity associated with a rhabdomyosarcoma. Clinical Chemistry. ,vol. 29, pp. 1549- 1550 ,(1983) , 10.1093/CLINCHEM/29.8.1549
Kazuki Teramachi, Naoki Kanomata, Takahiro Hasebe, Genichiro Ishii, Masanori Sugito, Atsushi Ochiai, Carcinosarcoma (pure endocrine cell carcinoma with sarcoma components) of the stomach. Pathology International. ,vol. 53, pp. 552- 556 ,(2003) , 10.1046/J.1440-1827.2003.01508.X
Yoshifuku Nakayama, Hiroshi Murayama, Hiroshi Iwasaki, Shin-ichi Iwanaga, Masahiro Kikuchi, Seiyo Ikeda, Mitsuo Okada, Yoshihiko Iizuka, Akinori Iwashita, Gastric carcinosarcoma (sarcomatoid carcinoma) with rhabdomyoblastic and osteoblastic differentiation. Pathology International. ,vol. 47, pp. 557- 563 ,(1997) , 10.1111/J.1440-1827.1997.TB04540.X
Karl R. Fox, Samir M. Moussa, Ricardo J. Mitre, Bernard L. Zidar, John J. Raves, Clinical and pathologic features of primary gastric rhabdomyosarcoma Cancer. ,vol. 66, pp. 772- 778 ,(1990) , 10.1002/1097-0142(19900815)66:4<772::AID-CNCR2820660429>3.0.CO;2-R
Y Sato, T Shimozono, S Kawano, K Toyoda, K Onoe, Y Asada, T Hayashi, Gastric carcinosarcoma, coexistence of adenosquamous carcinoma and rhabdomyosarcoma: a case report. Histopathology. ,vol. 39, pp. 543- 544 ,(2001) , 10.1046/J.1365-2559.2001.1301E.X
Koichi Tsuneyama, Motoko Sasaki, Amura Sabit, Katsumi Yokoi, Yoshihiko Arano, Tetsuya Imai, Yasuni Nakanuma, A case report of gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation. Pathology Research and Practice. ,vol. 195, pp. 93- 97 ,(1999) , 10.1016/S0344-0338(99)80077-6
Susumu Matsukuma, Ryo Wada, Kazuo Hase, Yu Sakai, Sho Ogata, Noriyuki Kuwabara, Gastric stump carcinosarcoma with rhabdomyosarcomatous differentiation Pathology International. ,vol. 47, pp. 73- 77 ,(1997) , 10.1111/J.1440-1827.1997.TB04438.X
Hitoshi FUJII, Kazuhiro IWASE, Jun HIGAKI, Shoki MIKATA, Masami IMAKITA, Wataru KAMIIKE, A CASE OF GASTRIC CARCINOSARCOMA ACCOMPANIED BY GASTRIC GASTROINTESTINAL STROMAL TUMOR Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association). ,vol. 63, pp. 2934- 2937 ,(2002) , 10.3919/JJSA.63.2934