原发性心脏未分化多形性肉瘤一例

患者男,61岁。因咳嗽、咳痰伴活动后胸闷、气喘15 d入院。患者入院15 d前受凉后出现咳嗽、咳痰,呈阵发性,伴有活动后胸闷、气喘,病初有发热,曾自服青霉素V钾片、头孢类抗生素,体温控制,但咳喘无改善。入院查体:神志清楚,右侧胸廓饱满,右侧触觉语颤减低,叩诊右下肺呈浊音,听诊两肺呼吸音粗,右下肺呼吸音减低,可闻及散在干湿性啰音。     

肠系膜未分化多形性肉瘤1例报告

正未分化多形性肉瘤(undifferentiated pleomorphic sarcoma,UPS)好发于四肢深部,其次为后腹膜区~([1-2]),肠系膜UPS在临床上则非常罕见。笔者医院近期收治1例,诊治效果良好。报告如下。1病历简介病人女性,61岁。因左中腹疼痛1月余,加重1周于2016-03-29入院。外院B超示:胆囊结石,胆囊炎、脾脏肿大。既往有子宫肌瘤行全子     

右侧大腿巨大未分化多形性肉瘤1例

患者,男,65岁,发现右大腿外侧肿物3月余,于2019 年8 月12 日至广州医科大学附属第三医院就诊.查体:右大腿外侧约18 cm × 10 cm × 6 cm 大小肿物,质地韧,活动性差,无压痛,可见肿物表面皮肤紧绷,静脉血管明显.右大腿MRI检查显示(见图1A):右大腿外侧见不规则软组织团块影,约 8. 9 cm...     

骨盆巨大未分化高级别多形性肉瘤1例

未分化高级别多形性肉瘤在国内的发病率为1/10万,占原发恶性骨肿瘤的3%～5%.常发生于40岁以上成年人,男女之比为1.2:1,好发部位主要在四肢,其次为躯干[1].     

升结肠原发未分化多形性肉瘤1例报告

未分化多形性肉瘤( undifferentiated pleiomorphic sarcoma,UPS)既往被称为恶性纤维组织细胞瘤( malignant fibrous histiocy-toma,MFH),是常见的软组织肉瘤,多发生于四肢[1],预后较差,2年生存率与5年生存率仅为60％与47％[2],原发于结肠的...     

腹膜后巨大未分化多形性肉瘤并卵巢畸胎瘤一例

患者女,65岁,因发现腹部包块3个月入院。患者3个月前乘车时发现腹部坠胀痛,左腹部发现一圆形包块,活动度好,伴腹胀,无腹泻,无恶性、呕吐,未给予治疗。此后包块逐渐增大,伴进食量较前减少,为求进一步治疗,来院就诊。     

骨未分化高级别多形性肉瘤诊治进展

骨未分化高级别多形性肉瘤（BUPS）为一种少见的恶性骨肿瘤,其组织学来源及分化方向尚不明确。该病影像学表现缺乏特征性,早期诊断及早期规范化治疗是影响其预后的关键因素。目前BUPS 的治疗以手术为主,辅以手术前后化疗和术后放疗。分子生物治疗的发展和应用使其治疗模式日益多样化和精确化。该文就近年来 BUPS 的诊断与治疗研究进展作一综述。     

肝脏未分化胚胎肉瘤一例

肝脏未分化肉瘤，又称胚胎肉瘤(undifferentiated embryonal sarcoma of liver，USL)，临床少见。随着影像诊断技术及肝脏外科的迅速发展，此病的发现可能会有增加。作者就经治的1例成人USL,并复习文献加以讨论，以提高对本病的诊治。     

原发性左心房未分化肉瘤一例

患者女,14岁。因发热、咳嗽18d,做彩色超声心动图检查发现左心房占位5d入院。查体:心率140次/分,律齐,心尖区可闻及3/6级舒张期杂音,余心肺未见异常。胸部X线片示:双肺纹理增多,心影稍增大。心电图示:窦性心动过速,140次/分,电轴右偏 185°。彩色超声心动图提示:左心房、右心室增大,左心房内见一大小约57mm×44mm×34mm椭圆形弱回声团块,呈分叶状,附着于左心房侧壁与顶壁之间近左上肺静脉口处,蒂短,蒂宽约15mm,随心脏舒张、收缩往返于左心室流入道与左心房之间,舒张期堵塞二尖瓣口(图1)。术前临床诊断:左心房占位(黏液瘤)。在全身麻醉中度…     

胰腺多形性未分化肉瘤：病例报告与文献回顾

背景与目的:多形性未分化肉瘤(UPS),既往称为恶性纤维组织细胞瘤(MFH)是一种间叶源性恶性肿瘤,占所有软组织肉瘤的20%以上,多发生于四肢、躯干及腹膜后。发生于胰腺的UPS极为罕见。国内、外虽有报道,但多以个案形式报道,缺少大宗病例资料分析。本研究就笔者团队诊治的1例胰腺UPS患者,结合文献,探讨其临床特点、诊疗及预后。方法:回顾分析内蒙古医科大学附属医院肝胆外科诊治的1例胰腺UPS患者的临床资料,同时检索国内外数据库中的相关文献资料,将同类病例资料汇总分析。结果:共32例(笔者单位1例加文献报告病例31例)纳入研究,其中男20例,女12例;中位年龄54.6(22~74)岁。按病理类型分为:巨细胞型9例,黏液型5例,多形性型18例;按发生部位分为:胰头13例,胰体尾12例,胰体3例,胰尾2例,全胰腺2例。术前诊断为胰腺癌8例,胰腺肿物及占位6例,假性囊肿4例,囊腺瘤4例,胰腺肿瘤3例,间质肿瘤1例,纤维肉瘤1例,炎性病变1例,未提及术前诊断4例。临床表现大多表现为快速软组织肿块进行性增大,常伴有压迫症状,可伴有恶心呕吐,上腹部不适、腹胀,体质量减轻或黄疸。所有患者的术前诊断中无正确诊断。32例均行手术治疗,围术期死亡1例,总生存期15.3个月。结论:胰腺UPS为高度恶性肿瘤,无明显特异性临床表现,极易发生转移及复发,预后差。早期、完整切除肿瘤以获得R0切除是手术治疗的核心,但是由于胰腺UPS的特殊组织生物学行为,在部分病例中即使施行广泛切除或根治性切除,仍不能避免肿瘤局部复发或远处转移。术后给予放化疗有可能能够改善患者的生存。     

Undifferentiated pleomorphic sarcoma in the left atrium; report of a case

Primary cardiac sarcomas are rare. A 41-year-old woman complaining of dyspnea was admitted to our hospital. Echocardiography and computed tomography (CT) showed a primary cardiac tumor in the left atrium. During surgery, the tumor was noted to be arising from the anterior wall of the left atrium, under the aortic sinuses. Histological and immunohistochemical studies revealed an undifferentiated pleomorphic sarcoma. Eleven months later, echocardiography and CT showed recurrence of the cardiac sarcoma in the left atrium. The patient underwent wide resection of the left atrium and mitral valve replacement because the tumor extended to the mitral valve leaflet. The patient died 3 months after the 2nd surgery because of the 2nd recurrence of the cardiac sarcoma. Although most tumors that develop in the left atrium are benign myxomas, preoperative differential diagnosis is important. It is especially necessary to suspect a sarcoma in the case of a non-septal orgin of the mass.     

Undifferentiated sarcoma of the prostate: report of a case

The authors report one case of indifferentiated sarcoma of the prostate revealed by phlebitis of the right inferior limb and lung's metastases in a man 41 years old. The tumor progress rapidly and infiltrate the bladder and the posterior urethra. The patient died five months later. They review the literature and study the clinical histological, therapeutic and evolutive aspects of this unusual tumor.     

Undifferentiated embryonal sarcoma of the liver: case report and literature survey

Undifferentiated embryonal sarcoma (UES) of the liver was first identified as an independent clinicopathologic type of sarcoma in 1978. It is an uncommon hepatic tumor, of mesenchymal origin, usually observed in children, and cases in adults are rare: to our best knowledge, reports of only 51 cases have been published in the past 50 years. We present a case of UES of the liver in a previously healthy 22 year-old woman, admitted to our hospital due to a palpable mass in the right upper abdomen. On admission, laboratory studies showed mildly elevated aspartate aminotransferase, alkaline phosphatase, and gamma-GPT. Hepatitis and tumor markers were negative. Ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) showed a large mass involving the right lobe and the medial segment of the liver, with compression of the bile duct. Right trisectionectomy with bile duct resection and reconstruction was performed. Microscopically, the tumor was composed of pleomorphic spindle cells in a myxoid stroma with focal staining of S-100 by immunohistochemistry. The histologic diagnosis was UES. Adjuvant therapy with vincristine, actinomycin-D, and cyclophosphamide was performed, and at 14 months of follow-up, the patient is alive without any evidence of recurrence. The clinical and histopathological features, as well as the therapeutic choices for adult UES, are described for this patient and in the literature of the past 50 years.     

Oral undifferentiated high-grade pleomorphic sarcoma: report of a case.

The current World Health Organization classification considers the existence of an undifferentiated unclassifiable category of pleomorphic sarcomas, defined as a group of pleomorphic high-grade sarcomas. Undifferentiated high-grade pleomorphic sarcoma represents about 5% of all soft tissue sarcomas in adults and occurs more commonly in the extremities. In the oral cavity, undifferentiated pleomorphic sarcoma is extremely rare. We report a case of undifferentiated high-grade pleomorphic sarcoma located in the floor of the mouth in a man 56 years old. Microscopically, spindle-shaped cells with accented pleomorphism arranged in a storiform pattern, several bizarre giant cells, and frequent atypical mitoses were observed. The tumor cells were positive only for vimentin, with focal positivity for CD68. The patient was treated by surgery and postoperative radiation therapy, and after 25 months, no recurrence was observed.     

前列腺未分化肉瘤伴软骨化生1例报道并文献复习

目的:探讨前列腺未分化肉瘤伴软骨化生的临床表现和病理特点,进一步明确其所属类别。方法:分析2009年2月收治的1例前列腺未分化肉瘤伴软骨化生患者的临床资料,对该例手术切除的肿瘤组织行常规HE及免疫组化染色,光镜下观察其组织结构和免疫组化表达,并结合文献复习其临床表现。结果:病理诊断:灰白色前列腺肿物,镜下见其含有软骨肉瘤和未分化肉瘤成分。免疫组化染色:波形蛋白(+),局部CD117(±)。平滑肌肌动蛋白、结蛋白、肌红蛋白、CD34、细胞角蛋白CK7、CK8均为(-)。术后2个月发现肿瘤转移,4个月后患者死亡。结论:本例患者为前列腺未分化肉瘤伴软骨化生,该例肿瘤是一种恶性程度较高的侵袭性肿瘤,非常罕见,需经病理检查和免疫组化来确诊。     

A case of undifferentiated pleomorphic sarcoma of a retro-gastric origin,case report and review of literature

Introduction and importanceUndifferentiated pleomorphic sarcoma (UPS) is one of the most common sarcomas affecting elderly patients, majority of UPS usually in the extremities, trunk, and retroperitoneum. However, its rarely observed in the digestive system. There are minimal data published regarding this topic.Case presentationHere we present a 58 years old female patient with a rare case of the pleomorphic sarcoma of retro-gastric mass measures about (24.7 × 23.5 × 17.4 cm) who underwent exploration laparotomy founded a freely and mobile retro-gastric mass measuring 30 × 20 cm with a cystic and solid component. The mass was freely and mobile located with no true gastric relation is the first one to be reported.Clinical discussionThe undifferentiated pleomorphic sarcomas or MFH has been regarded as the most common soft tissue sarcoma for many years (Kabashima et al., 2017). The incidence increases with age, with an inclusive incidence of about 1–2 cases per 100,000 patients per year, predominately 1.2:1 for males. Undifferentiated pleomorphic sarcoma of the stomach is rare and counted to have a worse prognosis when compared to the other types of pleomorphic malignant fibrous histiocytoma.ConclusionWe present a rare case of high-grade undifferentiated pleomorphic sarcoma of the retro-gastric mass with no invasion to the surrounding structures, managed with surgical resection of the tumor.     

Intrasellar pleomorphic xanthoastrocytoma: case report

OBJECTIVE AND IMPORTANCE: A patient with a primary intrasellar pleomorphic xanthoastrocytoma is described. CLINICAL PRESENTATION: A 78-year-old woman experienced slowly progressing bilateral visual disturbance. Analysis of magnetic resonance imaging scans indicated a well-enhanced tumor occupying intra- and suprasellar spaces with displacement of the pituitary gland anteriorly. INTERVENTION: Partial resection of the tumor via the transsphenoidal route brought about improvement of the patient's visual disturbance. The tumor was conspicuously pleomorphic and composed of plump to spindle-shaped large and bizarre cells with single or multiple nuclei and lipid-laden foamy cytoplasm. The neoplastic cells were positive for glial fibrillary acidic protein, S-100 protein, and vimentin. The MIB-1 antibody labeling index was very low (<1%) CONCLUSION: Pleomorphic xanthoastrocytoma should be included in the differential diagnosis of tumors arising in the posterior hypophysis.