郑雅文, 张新伟, 战忠利, 叶兆祥, 徐文贵, 王佩国, 郭志, 姚欣, 谢广茹, 黄鼎智, 任秀宝. 1例恶性嗜铬细胞瘤多发转移的多学科协作诊疗[J]. 中国肿瘤临床, 2013, 40(21): 1332-1336. DOI: 10.3969/j.issn.1000-8179.20131397
引用本文: 郑雅文, 张新伟, 战忠利, 叶兆祥, 徐文贵, 王佩国, 郭志, 姚欣, 谢广茹, 黄鼎智, 任秀宝. 1例恶性嗜铬细胞瘤多发转移的多学科协作诊疗[J]. 中国肿瘤临床, 2013, 40(21): 1332-1336. DOI: 10.3969/j.issn.1000-8179.20131397
Yawen ZHENG, Xinwei ZHANG, Zhongli ZHAN, Zhaoxiang YE, Wengui XU, Peiguo WANG, Zhi GUO, Xin YAO, Guangru XIE, Dingzhi HUANG, Xiubao REN. Multi-disciplinary diagnosis and treatment of a malignant pheochromocytoma with multiple metastases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(21): 1332-1336. DOI: 10.3969/j.issn.1000-8179.20131397
Citation: Yawen ZHENG, Xinwei ZHANG, Zhongli ZHAN, Zhaoxiang YE, Wengui XU, Peiguo WANG, Zhi GUO, Xin YAO, Guangru XIE, Dingzhi HUANG, Xiubao REN. Multi-disciplinary diagnosis and treatment of a malignant pheochromocytoma with multiple metastases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(21): 1332-1336. DOI: 10.3969/j.issn.1000-8179.20131397

1例恶性嗜铬细胞瘤多发转移的多学科协作诊疗

Multi-disciplinary diagnosis and treatment of a malignant pheochromocytoma with multiple metastases

  • 摘要: 恶性嗜铬细胞瘤是起源于嗜铬组织的罕见恶性肿瘤,是否发生转移是判断其良恶性的标准。本例患者以多发肝、肺、骨转移就诊,查多项肿瘤标志物、胃镜、胸腹强化CT、PET-CT均难以确诊,行肝转移瘤穿刺活检,病理示:(肝右叶)恶性神经内分泌肿瘤,结合右侧肾上腺嗜铬细胞瘤切除术病史及免疫组织化学结果,考虑为恶性嗜铬细胞瘤肝、肺、骨转移。目前恶性嗜铬细胞瘤尚无标准治疗,文献报道使用CVD方案(环磷酰胺、长春新碱、达卡巴嗪)和靶向药物舒尼替尼能取得一定治疗效果。本例患者接受2个周期CVD化疗及1个疗程索坦治疗后,疾病仍缓慢进展。通过多学科讨论,认为131I-MIBG(131I-间位碘苄胍)可以作为该患者下一步治疗的选择。

     

    Abstract: Malignant pheochromocytomas are rare tumors that arise from chromaffin tissue, and the diagnostic criterion of malignancy is based on the development of metastases. In the case a patient suffers the tumor with liver, lung and bone metastases. However, the test results of tumor markers, gastroscopy, chest and abdominal CT, and PET-CT examination are hard to make a definite diagnosis. The patient was finally diagnosed with malignant pheochromocytoma with liver, lung and bone metastases following the needle biopsy of liver and underwent the excision of a right adrenal pheochromocytoma. Therapeutic standard for the malignant pheochromocytomas is not available so far. It is reported that chemotherapeutic CVD regimen (cyclophosphamide, vincristine, and daecarbazine) and sunitinib may be effectual in the alike cases. The patient received two cycles of CVD and one cycle of sunitinib, nevertheless, slow progression of the disease remained after the treatment. The results of multi-disciplinary treatment have suggested that 131I-MIBG may just be a choice for this patient.

     

/

返回文章
返回