RESUMO
A 56-year-old man was referred with lower rectal cancer showing anal canal invasion and liver metastasis. He underwent an abdominoperineal resection and a partial hepatectomy. Adjuvant therapy with tegafur-uracil and leucovorin was administered postoperatively. Lung metastasis was detected 2 years later and was resected. Right mandibular metastasis was diagnosed 2 months after the resection of the lung metastasis. A partial mandibular resection was performed after chemoradiotherapy, followed by reconstruction with a titanium frame and oral cavity reconstruction with a greater pectoral musculocutaneous flap. The pathological diagnosis was metastatic rectal cancer, and the therapeutic effect chemoradiotherapy was Grade 2. He is presently alive without any evidence of cancer, and has maintained a good quality of life 3 years after the mandibular resection and more than 5 years after his first operation. Mandibular metastasis from rectal cancer is very rare and the prognosis is poor according to the literature, so this case is considered to be very unusual.
Assuntos
Neoplasias Mandibulares/secundário , Neoplasias Mandibulares/cirurgia , Neoplasias Retais/secundário , Neoplasias Retais/cirurgia , Terapia Combinada , Hepatectomia/métodos , Humanos , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Masculino , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/tratamento farmacológico , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Radiografia , Procedimentos de Cirurgia Plástica , Retalhos CirúrgicosRESUMO
We report a patient who had a giant pelvic solitary fibrous tumor (SFT) that was excised with the aid of aortic balloon occlusion. A 27-year-old woman was diagnosed, at another hospital, as having an inoperable intrapelvic tumor. On admission, computed tomography showed that the uterus, urinary bladder, and rectum were compressed anteriorly by a pelvic tumor with a maximum diameter of 16 cm. On magnetic resonance imaging, the tumor contained mesh-like structures showing strong intensity. Transanal needle biopsy was performed, and SFT was diagnosed by immunostaining. The tumor was supplied by feeding vessels from the inferior mesenteric artery and bilateral internal iliac arteries. Despite massive intraoperative hemorrhage, this giant tumor was excised with the help of aortic balloon occlusion. An intrapelvic SFT should be resected after careful preparation of countermeasures for hemorrhage.