RESUMO
We report here a case of synchronous dermoid cyst with secondary malignant tumor and uterine endometrial adenocarcinoma that responded to UFT. A 35-year-old female complained of abdominal fullness and visited our hospital. She had an abdominal mass which was newborn-head size. We performed right salpingo-oophorectomy and partial omentectomy. The pathological findings were dermoid cyst with secondary malignant transformation. After the operation she had underwent cyclic chemotherapy with CDDP, CPA, THP and 5-FU. After three cycles of chemotherapy, a uterine recurrence was suspected from her uterine endocervical smear test. Then we performed a second operation, but radical surgery was impossible due to the presence of multiple metastases to pelvic lymph nodes. The pathological findings were primary uterine endometrial adenocarcinoma, not metastasis from dermoid cyst with secondary malignant tumor. After the second operation, she was treated with oral UFT (400 mg/day), as she refused chemotherapy and radiotherapy. Two months after the start of UFT, the tumor markers were reduced remarkably, and the patient maintained good QOL throughout the treatment without serious adverse events. We conclude that UFT might be benefical in the treatment of advanced gynecologic cancer.
Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/uso terapêutico , Cisto Dermoide/tratamento farmacológico , Neoplasias do Endométrio/tratamento farmacológico , Neoplasias Primárias Múltiplas , Neoplasias Ovarianas/tratamento farmacológico , Tegafur/uso terapêutico , Uracila/uso terapêutico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Carcinoma Adenoescamoso/patologia , Terapia Combinada , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Combinação de Medicamentos , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Histerotomia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Ovariectomia , Qualidade de Vida , SalpingostomiaRESUMO
Carcinosarcoma of the ovary is a very rare and highly malignant neoplasm that accounts for less than 1% of ovarian neoplasms. Survival of patients with advanced stage cancer is poor and the best treatment is not clear. We report the case of a 60-year-old woman who had Stage IV advanced heterogeneous ovarian carcinosarcoma with lung and liver metastases. The lesions were considered surgically incurable, so she was placed on neoadjuvant chemotherapy of combination CPT-11 (60 mg/m2, day 1, 15) and CDDP (60 mg/m2, day 1). Tumor markers of CA125 and LDH decreased remarkably to the normal level after 3 and 4 courses of chemotherapy, respectively. After 7 courses of chemotherapy, the ovarian tumor was obviously reduced, and the lung and liver metastases had disappeared. The patient was then able to undergo surgery. The current case suggests that combination CPT-11 and CDDP is effective against advanced ovarian carcinosarcoma.