Long-Term Survival in a Patient With Abdominal Sarcomatosis From Uterine Leiomyosarcoma: Role of Repeated Laparoscopic Surgery in Treatment and Follow-Up

详细信息    查看全文

• 作者：Antonio Macciò ; MD^a ; ^{a.maccio@tin.it" class="auth_mail" title="E-mail the corresponding author} ; Paraskevas Kotsonis ; MD^a ; Giacomo Chiappe ; MD^a ; Luca Melis ; MD^b ; Fausto Zamboni ; MD^c ; Clelia Madeddu ; MD^d
• 关键词：Abdominal sarcomatosis ; Leiomyosarcoma ; Laparoscopy ; Quality of life
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：23
• 期：6
• 页码：1003-1008
• 全文大小：1585 K

文摘

Uterine leiomyosarcoma (LMS) in some cases may disseminate through the abdominal cavity, without extra-abdominal spreading, determining a condition of abdominal sarcomatosis, which represents a peculiar situation. Only radical surgical removal offers a chance of long-term survival in such cases of LMS. Here we describe a case of diffuse abdominal sarcomatosis from uterine LMS in a 51-year-old perimenopausal woman who underwent laparoscopic radical hysterectomy, bilateral salpingo-oophorectomy, total pelvic peritonectomy, pelvic lymphadenectomy to the mesenteric inferior artery, and omentectomy. Then, given the high probability of disease recurrence, the patient underwent a close follow-up consisting of positron emission tomography (PET)/computed tomography every 3 months and diagnostic (and if necessary operative) laparoscopy every 6 months. To date, the patient had 11 laparoscopies; 5 of them were preceded by a PET indicative of the presence of disease with high metabolic activity, which was confirmed at surgery and each time completely removed laparoscopically with no evidence of residual disease. To date, 5 years from diagnosis the patient is alive and continues her follow-up. Our report brings to light the ability of laparoscopic surgery to obtain disease control in a case of LMS with abdominal dissemination. Moreover, laparoscopic surgery, as demonstrated in our case, may have an important role in the close follow-up of the disease and allow a timely and early radical surgical approach of relapses before they become extremely large and difficult to remove radically.