肝脏转移性平滑肌肉瘤5例临床诊治分析

Clinical diagnosis and treatment of metastatic liver leiomyosarcoma in 5 cases

目的 探讨肝脏转移性平滑肌肉瘤(MLL)的临床特征、治疗方法及效果.方法 回顾性分析5例MLL的临床特点,包括4例腹膜后平滑肌肉瘤肝转移和1例子宫平滑肌肉瘤肝转移;同时性肝转移1例,非同时性肝转移4例,均距原发灶手术超过2年.并对接受手术的4例患者的手术方式、术后辅助治疗及随访结果进行分析.结果 1例于诊断MLL后2年内死亡,该患者未经肝转移瘤手术治疗.2例接受手术治疗者于3年内死亡,目前仍有2例存活,1例生存36个月,1例生存29个月.结论 MLL多发生于原发灶切除后数年内,手术治疗是MLL主要的治疗方法,可以明显延长患者的生态期.

Objective To investigate the clinical features,treatment methods of metastatic liver leiomyosarcoma(MLL).Methods The characteristics of 5 cases of MLL were reviewed and summarized.Among them,4 cases were derived from retroperitoneal leiomyosarcoma and 1 case was derived from uterine leiomyosarcoma.In terms of metastasis time,1 case was simultaneous liver metastasis and 4 cases were heterochronous liver metastases,all of which were more than 2 years away from the primary tumor resection.Results One patient died within 2 years after the diagnosis of MLL,and this patient had not undergone surgical treatrnent for liver metastases.Of the 4 patients who had had the metastasis resection,2 patients died within 3 years.Currently,2 patients are alive,1 patient after 36 months,and 1 patient after 29 months.Conclusion MLL occurs mostly years after the primary tumor is removed.Currently,surgical treatment is considered to be the main treatment method for MLL,which can significantly prolong the patients survival.