Long-Term Survival in a Patient With Abdominal Sarcomatosis From Uterine Leiomyosarcoma: Role of Repeated Laparoscopic Surgery in Treatment and Follow-Up
| Autor: | Giacomo Chiappe, Antonio Macciò, Paraskevas Kotsonis, Fausto Zamboni, Luca Melis, Clelia Madeddu |
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| Rok vydání: | 2016 |
| Předmět: |
Leiomyosarcoma
Laparoscopic surgery Reoperation medicine.medical_specialty medicine.medical_treatment Ovariectomy Aftercare Abdominal cavity Hysterectomy 03 medical and health sciences Salpingectomy 0302 clinical medicine Positron Emission Tomography Computed Tomography Abdomen medicine Humans Survivors Laparoscopy 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics and Gynecology Sarcomatosis Sarcoma Middle Aged medicine.disease Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Uterine Neoplasms Lymph Node Excision Female Neoplasm Recurrence Local business |
| Zdroj: | Journal of minimally invasive gynecology. 23(6) |
| ISSN: | 1553-4669 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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