腎臟保留手術治療雙側平滑肌惡性肉瘤腎臟轉移
陳一中1、江百凱1、陳建志1、林文榮1、邱文祥1,2
馬偕紀念醫院 泌尿科1；馬偕醫學院；陽明醫學院2
Nephron-Sparing Surgery for Leiomyosarcoma with Bilateral Renal Metastases
Yi-Zhong Chen1, Pai-Kai Chiang 1, Marcelo Chen1, Wun-Rong Lin1, Allen W. Chiu1, 2
Department of Urology, MacKay Memorial Hospital1; Mackay Medical College1;
School of Medican, National Yang-Ming University2
Introduction: Retroperitoneal leiomyosarcoma is a rare tumor of all soft tissue sarcomas. We report on a 49-year-old female patient with history of retroperitoneal leiomyosarcoma with bilateral renal metastases for nine-year survival.
Case: This 49 year-old female was found to have retroperitoneal leiomyosarcoma and underwent tumor resection in 2007. In 9-year of follow up, she developed metastases to the paraspinal muscle, right upper lung and left arm, for which she underwent multiple times of surgery and local radiotherapy. Recurrent metastatic high-grade leiomyosarcoma involving bilateral kidneys, sacrum, paraspinal muscle and pancreatic head developed during follow up. Bilateral partial nephrectomies were performed and no recurrence of follow up in bilateral kidney and her renal function was well preserved. The patient eventually died due of pancreatic head metastasis.
Due to long survival time of leimyosarcoma, we suggest aggressively do surgical intervention for renal metastatic tumor to keep life quality of patient, especially for young patient. We discuss the treatment modalities and the issues related to quality of life and psychological status in patients with this deliberating disease