盆腹腔内恶性肿瘤脐转移三例临床分析

Umbilical metastasis from malignant neoplasms of pelvic and abdominal cavity with 3 cases analysis

目的 探讨盆腹腔内恶性肿瘤脐转移 (SisterMaryJosephnodule ,SMJN)的发生率、转移途径、治疗和预后。方法 对 1987～ 2 0 0 1年间收治的 3例SMJN患者的临床资料进行回顾性分析及文献复习。结果 3例盆腹腔内恶性肿瘤的原发病分别为原发性腹膜癌 1例、卵巢黏液性乳头状腺癌 1例和子宫内膜癌 1例 ,3例患者经病理检查证实均为SMJN ,其中例 3术前针吸涂片为腺癌。治疗原则为尽量手术切除原发灶和转移灶后 ,辅以化学药物治疗 (化疗 )和放射治疗 (放疗 )。患者平均生存期为 63个月 ,除例 1死于原发性腹膜癌广泛转移外 ,例 2和例 3现已分别存活 5 8和 44个月。结论SMJN虽发生率低 ,但是恶性肿瘤晚期和预后差的标志。如果患者一般状况良好 ,应积极手术切除脐部转移性癌灶 ,术后辅助化疗和 (或 )放疗。

Objective To study the incidence, spreading path, prognosis and treatment of the umbilical metastasis Sister Mary Joseph nodule (SMJN) from malignancies Methods To analyse the clinical feature from 3 cases of SMJN and to review pertinent literatures Results Three cases SMJN were come from advanced primary peritoneal carcinoma in case 1, recurrent mucinous ovarian papillary adenocarcinoma in case 2 after primary cytoreductive surgery and systemic chemotherapy and case 3 with recurrent endometrial carcinoma All patients received umbilical resection and the umbilical metastasis was comfirmed pathologically, while case 3 was diagnosed adenocarcinoma spreading by fine needle respiration before the surgery The mean survival was 63 months following surgery or chemotherapy or radiotherapy, case 1 died of advanced malignancy, while case 2 and case 3 were still alive 58 and 44 months, respectively Conclusions Although the incidence being low, SMJN was the important sign of one of the vast metastatic malignancy and has grave prognosis Umbilical resection should be performed on some patients of SMJN with relative good condition, and chemotherapy or radiotherapy should also performed accordingly