同时性多原发癌伴肝转移1例并文献复习

目的 探讨同时性多发性骨髓瘤和结肠癌的病因、诊断及治疗方法。方法 对1例同时诊断为多发性骨髓瘤和结肠癌并继发肝转移患者的临床资料及相关文献进行回顾性分析。结果 患者以贫血为首发症状，骨髓穿刺术提示多发性骨髓瘤，荧光原位杂交检测示14q32 IgH基因重排阳性，肠镜及病理活检明确诊断结肠癌，数月后继发肝占位。给予VTD方案减轻骨髓负荷后行结肠癌切除术，术后采用VTD与XELOX联合方案化疗，肝占位行局部肝病损射频消融术，患者可耐受，肝转移灶较前明显缩小。 结论 同时性多发性骨髓瘤和结肠癌并伴肝转移罕见，需组织病理检查鉴别诊断原发癌与转移癌，治疗上尚无统一标准，需多学科评估制定治疗方案。

Simultaneous multiple primary carcinomas with liver metastasis: a case report and literature review

Objective To investigate the etiology,diagnosis and treatment options of simultaneous multiple myeloma and colon cancer.Methods The clinical data of 1 case of the multiple myeloma and colon cancer patient with secondary liver metastasis were retrospectively analyzed,and the relevant literature was reviewed.Results Anemia was the first symptom of the patient,and multiple myeloma was indicated by bone marrow aspiration.The positive of 14 q32 IgH gene rearrangement was revealed by fluorescence in situ hybridization,the colon cancer was diagnosed by colonoscopy and pathological biopsy,and the space occupying liver lesion was found a few months later.The colon cancer resection surgery was performed after VTD regime relieved the bone marrow load,then VTD and XELOX combined chemotherapy was performed postoperatively,and local radiofrequency ablation of liver lesions was performed for liver occupying space,the patient could tolerate it,and the liver metastases were significantly smaller than before.Conclusion Simultaneous multiple myeloma and colon cancer with liver metastasis are rare,the histopathology examination is necessary for differential diagnosis of primary and metastatic carcinoma,the treatment of which has not been standardized,the therapeutic plan need to be developed by the multidisciplinary assessment.