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巨大腹膜后平滑肌肉瘤伴出血1例报告并文献复习
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作者 蒋超 刘雪岩 +2 位作者 孙大伟 张平 王蒙 《中国普通外科杂志》 CAS CSCD 北大核心 2019年第6期737-742,共6页
目的:探讨腹膜后平滑肌肉瘤的临床特点、影像学表现及治疗策略,以期对类似病例的诊治提供参考。方法:回顾性分析收治的1例腹膜后平滑肌肉瘤患者临床资料,并复习相关文献。结果:患者腹部胀痛伴贫血,影像学提示中下腹部恶性肿瘤伴出血,早... 目的:探讨腹膜后平滑肌肉瘤的临床特点、影像学表现及治疗策略,以期对类似病例的诊治提供参考。方法:回顾性分析收治的1例腹膜后平滑肌肉瘤患者临床资料,并复习相关文献。结果:患者腹部胀痛伴贫血,影像学提示中下腹部恶性肿瘤伴出血,早期行液体复苏,进一步介入栓塞,超声引导下穿刺引流,避免腹腔隔室综合征的发生;复查待瘤体缩小,贫血纠正,行完整切除肿瘤,病理诊断为平滑肌肉瘤。术后随访16个月,患者恢复良好。结论:腹膜后平滑肌肉瘤是一种罕见的恶性肿瘤,起病隐匿,易复发和转移,手术完整切除是其主要治疗方式,配合以化疗、放疗等手段综合治疗,可改善患者预后。 展开更多
关键词 腹膜后肿瘤 平滑肌肉瘤 预后 病例报告
原发性胰腺平滑肌肉瘤1例病例报告并文献复习 预览
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作者 李为 胡明道 陈鹏 《世界最新医学信息文摘(电子版)》 2019年第42期229-230,共2页
原发性胰腺平滑肌肉瘤为临床极其罕见的恶性肿瘤,因其缺乏典型的临床症状,常导致误诊或延误诊治,临床预后较差。本文报道一例原发性胰腺平滑肌肉瘤一例并文献复习。
关键词 平滑肌肉瘤 诊断 侵袭
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Recalcitrant distal humeral non-union following previous Leiomyosarcoma excision treated with retainment of a radiated nonangiogenic segment augmented with 20 cm free fibula composite graft: A case report 预览
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作者 Martin Gathen Grayson Norris +1 位作者 Simon Kay Peter V Giannoudis 《世界骨科杂志(英文版)》 2019年第4期212-218,共7页
BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle tumors. Adjuvant radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up p... BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle tumors. Adjuvant radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up pathological fractures are common complications that can be accompanied by Implant failure and defect situations that are most challenging in their management. CASE SUMMARY We present a case of a 52-year-old female suffering from a pathological fracture of the humeral shaft 10 yr after resection of a Leiomyosarcoma and postoperative radiotherapy. She developed implant failure after retrograde nailing and another failure after revision to double plate fixation. In a two-stage revision, the implants were removed and the huge segmental defect created after debridement was bridged by a compound osteosynthesis with nancy nails and bone cement for formation of the induced membrane. Due to the previous radiotherapy treatment, 20 cm of the humeral shaft were declared devascularized but were left in situ as a scaffold. In the second stage, a vascularized fibula graft was used in combination with a double plate fixation and autologous spongiosa grafts for final reconstruction. CONCLUSION This combinatory treatment approach led to a successful clinical outcome and can be considered in similar challenging cases. 展开更多
关键词 Humerus FIBULAR graft Bone tumor OSSEOUS defect Implant failure LEIOMYOSARCOMA Case report
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IMP3、Ki-67、P53、Bcl-2在不同子宫平滑肌肿瘤中的表达 预览
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作者 刘裴丽 张亚军 蒋欣 《中国继续医学教育》 2019年第18期71-73,共3页
目的探讨IMP3、Ki-67、P53、Bcl-2在子宫平滑肌肿瘤中的表达及意义。方法采用免疫组化法检测34例良性子宫平滑肌瘤(UL)、40例交界性子宫平滑肌瘤(BLM)和35例子宫平滑肌肉瘤(LMS)中IMP3、Ki-67、P53、Bcl-2的表达。结果(1)IMP3在UL、BLM... 目的探讨IMP3、Ki-67、P53、Bcl-2在子宫平滑肌肿瘤中的表达及意义。方法采用免疫组化法检测34例良性子宫平滑肌瘤(UL)、40例交界性子宫平滑肌瘤(BLM)和35例子宫平滑肌肉瘤(LMS)中IMP3、Ki-67、P53、Bcl-2的表达。结果(1)IMP3在UL、BLM及LMS中的阳性表达率为0、5%及54.3%,差异有统计学意义(P<0.01);BLM与LMS组间比较(P<0.01),而BLM与UL组比较(P>0.05);(2)Ki-67、P53在UL、BLM、LMS组中的表达率均逐步升高,差异有统计学意义(P<0.05),且LMS组均高于BLM组(P<0.05);(3)Bcl-2在UL、BLM、LMS组中的表达率逐步下降,差异有统计学意义(P<0.01),且BLM组高于LMS组(P<0.05);(4)在109例标本中,对LMS检测的敏感度:Ki-67>P53>IMP3>Bcl-2;而检测的特异度:IMP3>P53>Ki-67>Bcl-2。结论IMP3有助于良恶性子宫平滑肌肿瘤的区别,IMP3、Ki-67、P53及Bcl-2在不同组别子宫平滑肌肿瘤中表达情况各异,联合检测可用于提高子宫平滑肌肉瘤的诊断率。 展开更多
关键词 IMP3 KI-67 P53 BCL-2 子宫平滑肌瘤 子宫平滑肌肉瘤
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阿帕替尼降低平滑肌肉瘤瘤体微血管密度的病例验证 预览
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作者 季艳霞 康振桥 +3 位作者 赵艳争 杨慧敏 王忠瑜 郭青 《安徽医药》 CAS 2019年第12期2501-2503,I0003,共4页
目的观察阿帕替尼治疗前后瘤体微血管密度的变化。方法选择2016年5月邯郸市中心医院收治的1例平滑肌肉瘤病人,第1次根治手术组织行免疫组织化学染色,术后行6周期化疗,腹部CT提示复发后口服阿帕替尼250 mg,每天1次,治疗5.5个月再次复发... 目的观察阿帕替尼治疗前后瘤体微血管密度的变化。方法选择2016年5月邯郸市中心医院收治的1例平滑肌肉瘤病人,第1次根治手术组织行免疫组织化学染色,术后行6周期化疗,腹部CT提示复发后口服阿帕替尼250 mg,每天1次,治疗5.5个月再次复发后行第2次手术取病理,组织免疫组织化学CD34染色,观察阿帕替尼治疗前后瘤体微血管密度的变化情况。结果阿帕替尼治疗平滑肌肉瘤,治疗后瘤体微血管密度显著降低,腹部CT提示4个月后腹腔肿瘤较前缩小。结论阿帕替尼可降低平滑肌肉瘤微血管密度,从而抑制肿瘤生长。 展开更多
关键词 平滑肌肉瘤 阿帕替尼 微血管 内皮生长因子 结肠成像 计算机体层摄影 微血管密度
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子宫平滑肌肉瘤并腔静脉及右心转移1例报告
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作者 李外星 孙信 +1 位作者 邓新粮 伍文 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2019年第2期254-256,共3页
子宫平滑肌肉瘤主要来源于子宫肌层的平滑肌细胞,可单独存在或与子宫肌瘤并存,是最常见的子宫肉瘤,约占子宫肉瘤的40%,大部分发生在40岁以上的女性,最常表现为腹痛、不规则阴道流血,绝经后阴道流血及迅速增大的盆腔包块等,手术是主要的... 子宫平滑肌肉瘤主要来源于子宫肌层的平滑肌细胞,可单独存在或与子宫肌瘤并存,是最常见的子宫肉瘤,约占子宫肉瘤的40%,大部分发生在40岁以上的女性,最常表现为腹痛、不规则阴道流血,绝经后阴道流血及迅速增大的盆腔包块等,手术是主要的治疗方式,术后可以结合化疗[1]。但复发率较高,为53%~71%,5年生存率约51%。现报道子宫平滑肌肉瘤并腔静脉及右心转移1例。 展开更多
关键词 平滑肌肉瘤 心脏肿瘤 子宫 肿瘤转移
Stathmin-1、Ki-67在子宫平滑肌肿瘤中的表达及意义 预览
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作者 胡仙清 林中民 +3 位作者 郑小冬 冯国飞 潘琼慧 朱雪琼 《医学研究杂志》 2019年第3期115-120,共6页
目的探讨Stathmin-1、Ki-67在子宫平滑肌肿瘤中的表达及其在子宫平滑肌肿瘤发生、发展中的作用。方法选取2013年1月~2016年6月于温州市人民医院及温州医科大学附属第一医院、第二医院的72例手术患者。根据组织病理学结果分为普通型子宫... 目的探讨Stathmin-1、Ki-67在子宫平滑肌肿瘤中的表达及其在子宫平滑肌肿瘤发生、发展中的作用。方法选取2013年1月~2016年6月于温州市人民医院及温州医科大学附属第一医院、第二医院的72例手术患者。根据组织病理学结果分为普通型子宫平滑肌肿瘤及瘤旁正常肌层组织30例,子宫富于细胞平滑肌肿瘤24例,子宫平滑肌肉瘤18例。采用免疫组化Envision二步法研究Stathmin-1、Ki-67在各组中的表达及临床病理学特征的相关性。结果Stathmin-1表达于细胞质,子宫平滑肌肉瘤组阳性表达率及染色分值高于另外3组(P均<0.05)。Ki-67表达于细胞核,子宫平滑肌肉瘤组阳性表达率及染色分值高于另3组(P均<0.05)。Stathmin-1与Ki-67染色分值在子宫平滑肌肉瘤组中存在正相关(rs=0.795,P=0.000)。Stathmin-1与Ki-67在子宫平滑肌肿瘤中的表达与患者年龄、肿瘤直径、数目等临床病理学特征均无相关(P均>0.05)。Stathmin-1联合Ki-67检测子宫平滑肌肉瘤的敏感度77.78%,特异性90.04%。结论Stathmin-1及Ki-67在子宫平滑肌肉瘤中的高表达可能与子宫平滑肌肉瘤的发生相关。联合检测Stathmin-1与Ki-67有助于早期辅助诊断子宫平滑肌肉瘤。 展开更多
关键词 子宫平滑肌肿瘤 肉瘤 Stathmin-1 KI-67
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Current status of the adjuvant therapy in uterine sarcoma: A literature review 预览
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作者 Alessandro Rizzo Maria Abbondanza Pantaleo +1 位作者 Maristella Saponara Margherita Nannini 《世界临床病例杂志》 2019年第14期1753-1763,共11页
Uterine sarcomas (US) are rare mesenchymal tumours accounting approximately for 3%–7% of all uterine cancers. Histologically, US are classified into mesenchymal tumours or mixed epithelial and mesenchymal tumours. Th... Uterine sarcomas (US) are rare mesenchymal tumours accounting approximately for 3%–7% of all uterine cancers. Histologically, US are classified into mesenchymal tumours or mixed epithelial and mesenchymal tumours. The group of mesenchymal tumours includes uterine leiomyosarcoma (uLMS, 65% of cases), endometrial stromal sarcoma (ESS, 21%)– traditionally divided into low grade (LG-ESS) and high grade–undifferentiated uterine sarcoma (5%) and other rare subtypes such as alveolar or embryonal rhabdomyosarcoma. Despite the fact that several drugs demonstrated clinical activity in advanced or metastatic settings, the role of postoperative therapy in US remains controversial. In this review, we have summarised the current state of the art, including the chief trials on adjuvant treatment modalities in US, especially focusing on uLMS, LG-ESS and other rare histotypes. 展开更多
关键词 UTERINE SARCOMA UTERINE LEIOMYOSARCOMA ENDOMETRIAL STROMAL SARCOMA ADENOSARCOMA Adjuvant therapy Chemotherapy Radiotherapy
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Leiomyosarcoma of the stomach: A case report 预览
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作者 Wen-Zhe Kang Li-Yan Xue Yan-Tao Tian 《世界临床病例杂志》 2019年第21期3575-3582,共8页
BACKGROUND Leiomyosarcoma of the stomach is extremely rare,and only 13 cases have been reported in the literature.Before the advent of KIT immunohistochemistry,gastrointestinal stromal tumors(GISTs)were misdiagnosed a... BACKGROUND Leiomyosarcoma of the stomach is extremely rare,and only 13 cases have been reported in the literature.Before the advent of KIT immunohistochemistry,gastrointestinal stromal tumors(GISTs)were misdiagnosed as leiomyomas and leiomyosarcomas.Leiomyosarcoma rarely occurs in organs besides the uterus and is rarely located in the stomach.CASE SUMMARY A 57-year-old woman presented with the symptom of melena over a one-month period.She had suffered weight loss,weakness,nausea and vomiting for fifteen days.At a local hospital,computed tomography showed a very large mass in the stomach,and the results of endoscopic examination and histopathological diagnosis were unclear.She received transfusion therapy and was transferred to our hospital.Upon arrival at our hospital,the patient was anemic.She denied any family history and had no specific past history.No signs of pulmonary metastasis were found on chest radiographs.Magnetic resonance imaging and computed tomography confirmed a very large tumor in the stomach,and no visible signs of metastatic disease were found.On October 30,2013,the patient underwent resection of the stomach tumor and did not undergo any adjuvant treatment.The margins were negative and she had an uneventful recovery and was discharged after 12 d.One year after surgery,the patient died at home,and the cause of death were gastrointestinal obstruction and malnutrition.During that time,she was treated with Chinese medicine but the effect was not ideal.Because of gastrointestinal obstruction,the patient did not receive any reexamination.CONCLUSION Surgical resection is the standard treatment for gastric leiomyosarcoma.The diagnosis of this tumor mainly depends on histopathological examination.This case may suggest the aggressive behavior and poor prognosis of this tumor. 展开更多
关键词 LEIOMYOSARCOMA STOMACH Case report KIT Gastrointestinal stromal tumor Targeted next-generation sequencing
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Systematic review of anorectal leiomyosarcoma: Current challenges and recent advances 预览
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作者 Mohammed O Nassif Razan A Habib +1 位作者 Luai Z Almarzouki Nora H Trabulsi 《世界胃肠外科杂志:英文版(电子版)》 2019年第8期334-341,共8页
BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LM... BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LMS characteristics, explore current treatment options, and review recent cases of postradiation LMS. METHODS A literature search of the PubMed electronic database was conducted using the MeSH terms "rectal neoplasms","anus neoplasms" and "gastrointestinal neoplasms" combined with "leiomyosarcoma". The search was limited to English language and human studies. All available case reports and case series of anal or rectal LMSs that were published from the beginning of January 1996 to May 2017 were included if the diagnosis of LMS had been confirmed by histopathologic examination. Data were analyzed using simple statistics (mean, median, and standard deviation). Independent sample t-test was used to compare means for continuous variables. RESULTS A total of 27 articles reporting on 51 cases of anorectal LMS were identified. Among these cases, 11.7% had undergone previous pelvic radiotherapy (developing LMS at 13-35 years afterwards). Anorectal LMS affected the rectum in 92.2% of the cases, and no sex-based predominance was observed. Surgical resection with negative margins remains the mainstay of treatment, which can be accomplished with wide local excision or radical resection. The local recurrence rate was higher among cases who received wide local excision (30%), as compared to radical resection (20%);however, the overall rate of metastasis was 51.61% regardless of the treatment approach. The use of neoadjuvant radiation lowers the risk of local recurrence compared to adjuvant radiotherapy, and facilitates R0 resection of the tumor. Cases treated with adjuvant chemotherapy showed better rates of distant recurrence and overall survival. Nonetheless, multidisciplinary team discussion is necessary to determine the optimal management plan whilst considering patient- and disease-related factors. CONCLUSION A 展开更多
关键词 LEIOMYOSARCOMA RECTAL NEOPLASMS ANAL NEOPLASMS GASTROINTESTINAL NEOPLASMS Soft tissue NEOPLASMS
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Primary hepatic leiomyosarcoma successfully treated by transcatheter arterial chemoembolization: A case report 预览
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作者 Ke-Lei Zhu Xiu-Jun Cai 《世界临床病例杂志》 2019年第4期525-531,共7页
BACKGROUND Primary hepatic leiomyosarcoma is rare and reported sporadically, with less than 40 such cases have been reported in the English-language literature. Although it is reported to be associated with acquired i... BACKGROUND Primary hepatic leiomyosarcoma is rare and reported sporadically, with less than 40 such cases have been reported in the English-language literature. Although it is reported to be associated with acquired immune deficiency syndrome, Epstein- Barr virus infection, Hodgkin’s lymphoma, immunosuppression after organ transplantation, and hepatitis C virus-related liver cirrhosis, the precise steps leading to leiomyosarcoma have not been fully identified. Therapeutic strategies include liver wedge resection or lobectomy, chemotherapy, radiotherapy and liver transplantation;however, the prognosis of primary hepatic leiomyosarcoma is dismal. CASE SUMMARY We describe here the first case of primary hepatic leiomyosarcoma successfully treated by transcatheter arterial chemoembolization (TACE). The patient was a 68-year-old woman who presented with right upper quadrant pain and weight loss over the past 5 wk before admission. Abdominal computed tomography (commonly known as CT) and ultrasonography showed a mixed echoic mass measuring about 10 cm × 7 cm occupying the right lobe of the liver. Exploratory laparotomy was performed 1 wk after admission. The tumor was unresectable and biopsy was performed. Based on rapid frozen-section and histopathological examination, a final diagnosis of primary hepatic leiomyosarcoma was established. TACE was performed 2 wk later. The postoperative course was uneventful and the patient was discharged on day 7 after the operation. Contrastenhanced CT showed that the tumor significantly shrunk with satisfactory lipiodol deposition. The patient has been followed up for 82 mo until now, and no progressive enlargement of the tumor or distal metastasis was observed. CONCLUSION TACE is a safe and effective treatment for primary hepatic leiomyosarcoma. The therapeutic effect of TACE combined with surgical resection should be further assessed. 展开更多
关键词 Treatment Prognosis TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION PRIMARY HEPATIC LEIOMYOSARCOMA Case report
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P16和P53在子宫平滑肌肿瘤中的表达与意义 预览
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作者 孔艳青 张雁瑞 +1 位作者 史健 陈莹莹 《齐齐哈尔医学院学报》 2019年第4期409-412,共4页
目的 目前已经有报道显示P16表达异常和子宫平滑肌肿瘤发生有密切关系,但在子宫平滑肌肿瘤中P16基因的作用似乎和大多数肿瘤有着明显的区别。为近一步探讨P16基因在子宫平滑肌肿瘤中的发生发展机制,本研究检测P16和P53在平滑肌肿瘤的表... 目的 目前已经有报道显示P16表达异常和子宫平滑肌肿瘤发生有密切关系,但在子宫平滑肌肿瘤中P16基因的作用似乎和大多数肿瘤有着明显的区别。为近一步探讨P16基因在子宫平滑肌肿瘤中的发生发展机制,本研究检测P16和P53在平滑肌肿瘤的表达情况。探讨P53和P16蛋白在子宫平滑肌肿瘤中的表达及临床意义。方法 应用免疫组织化学方法检测20例良性子宫平滑肌瘤、11例子宫平滑肌肉及17例恶性潜能未定型子宫平滑肌瘤的P53和P16蛋白的表达情况。结果 P16蛋白在平滑肌肉瘤组的阳性表达率显著高于恶性潜能未定型平滑肌瘤组及平滑肌瘤组(P<0.05)。P53蛋白在平滑肌肉瘤组的阳性表达率显著高于平滑肌瘤组(P<0.05)。结论 P53和P16蛋白的异常表达与子宫平滑肌瘤向子宫平滑肌肉瘤的转化可能存在相关性,并为临床鉴别子宫平滑肌肿瘤良恶性提供参考依据。P16高表达促进了子宫平滑肌肿瘤恶性发生发展还是恶性潜能未定型平滑肌瘤和平滑肌肉瘤形成后P16的高表达仅仅是一种结果,有待进一步研究。 展开更多
关键词 子宫平滑肌肿瘤 平滑肌肉瘤 P16 P53
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应用机器学习方法构建平滑肌肉瘤分子分型预测标签 预览
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作者 王强 安杨 +2 位作者 张国森 董寰 郭向前 《河南大学学报:医学版》 CAS 2019年第1期26-29,共4页
[目的]应用机器学习方法,利用TCGA与GEO数据,构建平滑肌肉瘤分子分型预测标签。[方法]收集TCGA和GSE45510数据,建立机器学习模型,利用pamr包预测标签,将预测亚型与实际值对比以评估预测效果。[结果]经测试,阈值取6.639时,分类准确率为87... [目的]应用机器学习方法,利用TCGA与GEO数据,构建平滑肌肉瘤分子分型预测标签。[方法]收集TCGA和GSE45510数据,建立机器学习模型,利用pamr包预测标签,将预测亚型与实际值对比以评估预测效果。[结果]经测试,阈值取6.639时,分类准确率为87.8%,相关基因159个。[结论]利用机器学习方法构建平滑肌肉瘤分子分型预测标签,可以用于预测平滑肌肉瘤分子亚型,提高诊断精度,指导未来平滑肌肉瘤亚型特异性靶向治疗,推动精准治疗发展。 展开更多
关键词 平滑肌肉瘤 表达谱 机器学习 分子分型 预测标签
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Primary leiomyosarcoma of the thyroid gland with prior malignancy and radiotherapy: A case report and review of literature 预览
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作者 Snezana Vujosevic Djordjije Krnjevic +4 位作者 Milan Bogojevic Ljiljana Vuckovic Aleksandar Filipovic Dusko Dunderovi Jelena Sopta 《世界临床病例杂志》 2019年第4期473-481,共9页
BACKGROUND Leiomyosarcoma (LMS) of the thyroid gland is a rarely presented tumor that offers poor prognosis. To the best of the authors’ knowledge, there currently exist only 28 known cases described in the literatur... BACKGROUND Leiomyosarcoma (LMS) of the thyroid gland is a rarely presented tumor that offers poor prognosis. To the best of the authors’ knowledge, there currently exist only 28 known cases described in the literature (limited to English). CASE SUMMARY Herein a case is reported of a 60-year-old female patient who had an LMS of the thyroid, which was accompanied by periodic dysphonia and breathing disorder as well as the feeling of pressure in the chest and neck. At the time the disease was diagnosed, no metastases were detected. Prior to the diagnosis, the patient experienced a uterine adenocarcinoma that had been treated by surgical procedure and radiotherapy. For the LMS, a total thyroidectomy was performed, followed by radiotherapy. Since metastases were also discovered in the lungs, sternum, and femur, chemotherapy was administered as well. Immunohistochemically, the tumor cells in the thyroid indicated positively for alpha smooth muscle actin, calponin, and H-caldesmon, but were negative for CD34, p63, estrogen receptor, progesterone receptor, and Epstein-Barr virus. CONCLUSION Although the etiology of the LMS is as of yet unknown, prior malignancy and radiation should be considered as risk factors. 展开更多
关键词 THYROID LEIOMYOSARCOMA SMOOTH muscle tumor RADIOTHERAPY THYROIDECTOMY Case report
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Multimodal treatments of right gastroepiploic arterial leiomyosarcoma with hepatic metastasis:A case report and review of the literature 预览
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作者 Hyung-Il Seo Dong-Il Kim +5 位作者 Youngsoo Chung Chang In Choi Minjoo Kim Sungpil Yun Suk Kim Do Youn Park 《世界临床病例杂志》 2018年第8期219-223,共5页
Leiomyosarcoma of an artery is very rare,and cases with hepatic metastasis are even rarer.We describe a case of a 70-year-old man who after follow up due to rectal cancer,presented with an intra-abdominal hypervascula... Leiomyosarcoma of an artery is very rare,and cases with hepatic metastasis are even rarer.We describe a case of a 70-year-old man who after follow up due to rectal cancer,presented with an intra-abdominal hypervascular mass and a hepatic mass.After surgical resection,it was diagnosed as a leiomyosarcoma of the right gastroepiploic artery with hepatic metastasis.Multiple metastases had recurred at the liver.He has survived more than 53 mo through multimodal treatments(three surgical resections,radiofrequency ablation,transarterial chemoembolization,chemotherapies,and targeted therapy).Multimodal treatments,including active surgical resection,may be helpful in the treatment of aggressive diseases such as arterial leiomyosarcoma with metastasis. 展开更多
关键词 MULTIMODAL TREATMENTS INTRA-ABDOMINAL ARTERIAL LEIOMYOSARCOMA Hepatic metastasis ARTERIAL LEIOMYOSARCOMA Surgical RESECTION
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子宫平滑肌肉瘤系统治疗 预览
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作者 罗攀 沈艳 +1 位作者 华腾 汪宏波 《国际妇产科学杂志》 CAS 2018年第5期495-499,共5页
子宫平滑肌肉瘤(uterine leiomyosarcoma,uLMS)是一种罕见的子宫间质肿瘤,其发病率低,是一种高度恶性肿瘤,即使是早期治疗,仍具有较高的复发率和转移风险。该疾病的术前诊断较困难,不如宫颈癌和子宫内膜癌有很好的诊断手段,术中存在... 子宫平滑肌肉瘤(uterine leiomyosarcoma,uLMS)是一种罕见的子宫间质肿瘤,其发病率低,是一种高度恶性肿瘤,即使是早期治疗,仍具有较高的复发率和转移风险。该疾病的术前诊断较困难,不如宫颈癌和子宫内膜癌有很好的诊断手段,术中存在治疗不足或治疗方式不恰当的情况,因此该疾病的预后较差。目前手术治疗仍是该疾病的主要治疗方案,术后的辅助治疗方案有很多,如辅助放疗、辅助化疗、靶向治疗、联合治疗或者进行随访观察,由于发病率低、研究的数量少以及疾病进展较快,迄今仍没有一个统一的标准治疗方案,且辅助治疗的效果不理想,临床获益较少。综述uLMS系统治疗的相关知识,尤其是在辅助治疗、转移病灶中以及意外中发现该疾病的治疗,为临床治疗提供参考性意见。 展开更多
关键词 子宫肿瘤 平滑肌肉瘤 抗肿瘤联合化疗方案 肿瘤治疗方案
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载药微球治疗腹膜后平滑肌肉瘤术后肝转移1例 预览
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作者 王辅明 刘敬禹 杨继金 《介入放射学杂志》 CSCD 北大核心 2018年第4期308-309,共2页
临床资料 患者女,54岁。2012年开始出现腹部轻微疼痛不适.后症状逐渐加重,2014年8月腹部CT检查发现腹膜后肿块。收我院普外科行腹膜后肿块切除术,术后病理及免疫组化结果诊断为腹膜后平滑肌肉瘤。2016年9月复查上腹部CT发现肝脏多... 临床资料 患者女,54岁。2012年开始出现腹部轻微疼痛不适.后症状逐渐加重,2014年8月腹部CT检查发现腹膜后肿块。收我院普外科行腹膜后肿块切除术,术后病理及免疫组化结果诊断为腹膜后平滑肌肉瘤。2016年9月复查上腹部CT发现肝脏多发转移瘤,考虑腹膜后平滑肌肉瘤术后肝转移。 展开更多
关键词 载药微球 平滑肌肉瘤 肝转移 经肝动脉化疗栓塞术
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多形性平滑肌肉瘤和去分化平滑肌肉瘤的临床病理学分析
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作者 孙蒙 刘尽国 +2 位作者 刘绮颖 喻林 王坚 《中华病理学杂志》 CSCD 北大核心 2018年第2期87-93,共7页
目的探讨多形性平滑肌肉瘤(PLMS)和去分化平滑肌肉瘤(DLMS)的临床病理学特征、鉴别诊断及生物学行为。方法回顾性分析2007年11月至2016年12月复旦大学附属肿瘤医院手术(8例)及会诊病例(41例)共49例PLMS和DLMS患者的临床资料、... 目的探讨多形性平滑肌肉瘤(PLMS)和去分化平滑肌肉瘤(DLMS)的临床病理学特征、鉴别诊断及生物学行为。方法回顾性分析2007年11月至2016年12月复旦大学附属肿瘤医院手术(8例)及会诊病例(41例)共49例PLMS和DLMS患者的临床资料、组织学形态和免疫学表型,其中33例有存档切片可供分析免疫表型,38例有随访资料。结果男性22例,女性27例;发病年龄24~83岁,平均52.5岁。肿瘤位于四肢15例,深部体腔14例,躯干11例,头颈部4例,膀胱2例,腹股沟、会阴部和股静脉各1例。肿瘤直径3~30 cm,平均9.1 cm。镜下观察:PLMS和DLMS具有大致相似的组织学形态,由经典平滑肌肉瘤(LMS)和多形性/未分化肉瘤成分组成,2种成分比例不等(至少局灶可见LMS成分),常相互混杂,亦可突然移行或逐渐过渡。其中,经典LMS成分呈典型平滑肌肿瘤特征,大多分化良好至中等,多形性/未分化肉瘤成分形态类似于未分化多形性肉瘤/恶性纤维组织细胞瘤。免疫组织化学表型方面,经典LMS成分至少表达1种肌源性标志物,多为强阳性,α-平滑肌肌动蛋白(α-SMA)、结蛋白、H-caldesmon、肌特异性肌动蛋白(MSA)和calponin的阳性比例分别为97.0%(32/33)、72.7%(24/33)、90.9%(20/22)、14/16和15/15。在29例(87.9%,29/33)中,多形性肉瘤成分至少表达1种肌源性标志物,多为局灶阳性或阳性强度较经典LMS成分弱:α-SMA、结蛋白、H-caldesmon、MSA和calponin的阳性比例分别为81.8%(27/33)、48.5%(16/33)、72.7%(16/22)、12/16和11/15。根据多形性肉瘤成分是否表达肌源性标志物,29例可归类为PLMS,4例为DLMS。Ki-67阳性指数为15%~70%,平均为40%。38例获得随访资料,11例(28.9%)死于该病,12例带瘤生存,14例无瘤生存,1例死于他因。中位无瘤生存和总生存时间分别为6个月和10个月。1 展开更多
关键词 平滑肌肉瘤 细胞去分化 免疫组织化学 诊断 鉴别
α-SMA和Ki-67的表达及其与原发性腹膜后平滑肌肉瘤患者预后的关系 被引量:1
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作者 马超 李沛雨 +3 位作者 张楠 孙成博 侯雷 刘娜 《中华肿瘤杂志》 CSCD 北大核心 2018年第4期258-263,共6页
目的探讨α-SMA和Ki-67的表达及其与原发性腹膜后平滑肌肉瘤患者预后的关系。方法回顾性分析2002年5月至2015年12月解放军总医院收治的50例腹膜后平滑肌肉瘤患者的临床病理资料。男14例,女36例:年龄21-79岁,平均年龄48岁。单因素生... 目的探讨α-SMA和Ki-67的表达及其与原发性腹膜后平滑肌肉瘤患者预后的关系。方法回顾性分析2002年5月至2015年12月解放军总医院收治的50例腹膜后平滑肌肉瘤患者的临床病理资料。男14例,女36例:年龄21-79岁,平均年龄48岁。单因素生存分析采用Kaplan.Meier法和Logrank检验,多因素生存分析采用Cox风险比例模型。结果50例患者中,完整切除45例,未完整切除5例。患者的生存时间为2-131个月,中位生存时间为35个月。患者的1、3、5年生存率分别为86.0%、46.0%和28.0%。单因素分析显示,肿瘤最大直径、手术切除程度、病理分级、α-SMA和Ki-67表达为患者预后的影响因素(均P〈0.05)。多因素分析显示,病理分级和手术切除程度为患者预后的独立影响因素(均P〈0.05)。结论腹膜后平滑肌肉瘤患者的预后较差,为达到肿瘤完整切除的目的,可根据术中情况联合周围器官切除。肿瘤过大、非完整切除、病理分级高、高表达Ki-67和α-SMA患者的预后差。 展开更多
关键词 平滑肌肉瘤 腹膜后肿瘤 预后 肌动蛋白类 KI-67 Α-SMA
腹膜后平滑肌肉瘤CT、MRI诊断与病理对比分析 预览 被引量:3
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作者 邵世虎 吴志远 +3 位作者 王忠敏 丁晓毅 曾小松 梅露 《中国医学计算机成像杂志》 CSCD 北大核心 2018年第3期224-228,共5页
目的:探讨、总结原发性腹膜后平滑肌肉瘤的CT、MR表现及临床病理特征。方法:回顾性分析经手术病理证实的23例原发性腹膜后平滑肌肉瘤的CT、MR影像学资料,并与病理结果作对照。结果:病灶多位于右侧腹膜后肾门附近或下腔静脉区,与邻... 目的:探讨、总结原发性腹膜后平滑肌肉瘤的CT、MR表现及临床病理特征。方法:回顾性分析经手术病理证实的23例原发性腹膜后平滑肌肉瘤的CT、MR影像学资料,并与病理结果作对照。结果:病灶多位于右侧腹膜后肾门附近或下腔静脉区,与邻近大血管关系密切;所有病灶均见囊变和坏死,多呈散在灶性且相对均匀分布,类似豹纹样改变;CT增强扫描肿瘤实性部分呈持续渐进性强化,个体间强化程度相差较大;MRI T1WI呈低信号,T2WI呈等或稍高信号,增强扫描强化方式与CT相似,DWI序列所有病灶均见弥散明显受限;肿瘤镜下细胞梭形,细胞密集,核质比大,见不同程度的核异型和核分裂。结论:PRLS病灶囊变、坏死常见,散在灶性相对均匀分布,颇具特征性;动态增强扫描CT、MRI均表现为持续渐进性强化的特点;MRI上病灶T2WI呈等或稍高信号,DWI序列上病灶弥散明显受限。 展开更多
关键词 腹膜后 平滑肌肉瘤 CT MRI 病理
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