鼻腔鼻窦腺样囊性癌放疗后诱发未分化多形性肉瘤1例报道

Undifferentiated pleomorphic sarcoma induced by the radiotherapy: a case report

摘要:

目的 总结鼻腔鼻窦腺样囊性癌放疗后诱发未分化多形性肉瘤（UPS）的诊疗经验。方法 回顾性分析1例鼻腔鼻窦腺样囊性癌术后4年放疗诱发未分化多形性肉瘤患者的临床资料，并结合文献进行分析。结果 患者于2015年1月行鼻侧切开上颌骨大部分切除术，术中完整切除肿瘤，术后病检结果提示为左侧上颌窦腺样囊性癌，术后规律行放化疗，2018年12月患者考虑肿瘤复发，行鼻侧切开左侧上颌骨次全切除术及鼻腔鼻窦肿瘤切除术，完整切除肿瘤，术后病理结果提示为UPS。结论 UPS是一种罕见的异质性实体肿瘤，其发病率低，恶性程度高，预后差，手术完整切除肿瘤仍然是目前最有效的治疗方法，多学科综合治疗对其预后有积极作用。

Abstract:

Objective To summarize the experience in the diagnosis and treatment of undifferentiated pleomorphic sarcoma (UPS) induced by radiotherapy for adenoid cystic carcinoma of the nasal cavity and sinuses. Methods The clinical data of one patient with (UPS) induced by the 4-year postoperative radiotherapy for the adenoid cystic carcinoma of nasal cavity and paranasal sinus were retrospectively analyzed through combining with literatures. Results The patient accepted a nasal lateral incision for the majority of maxillary resection in January 2015, in which the tumor was completely excised; the result of postoperative pathological examination showed that it was adenoid cystic carcinoma of the left maxillary sinus, thus postoperative radiotherapy and chemotherapy were performed regularly. In December 2018, the patient was considered to have tumor recurrence, therefore, the left maxillary subtotal resection and nasal cavity and paranasal sinus tumor resection were performed, and the tumor was completely removed, the postoperative pathological result indicated that it was undifferentiated pleomorphic sarcoma. Conclusions Undifferentiated pleomorphic sarcoma is a rare heterogeneous solid tumor of low incidence, high malignancy and poor prognosis. Complete surgical resection of the tumor is still the most effective treatment for UPS. Multidisciplinary treatment for UPS has positive effect on prognosis.