摘要
本文报告一例以双侧足趾疼痛、足部皮肤散发黑点起病的57岁男性患者,1个月后经皮肤活检和病理检查确诊血管肉瘤,在确诊前已经^(18)F-FDG PET-CT发现腰椎、骨盆、双下肢多发骨转移。患者接受单次表柔比星化疗后出现进行性左侧足趾、右侧第一足趾坏疽,双下肢血管CTA提示腹主动脉及双侧髂总动脉狭窄,最终接受腹主动脉、双侧髂总动脉支架植入和左足截趾治疗。患者每月接受地舒单抗注射液治疗,病情得到部分控制。血管肉瘤起病隐匿、进展迅速,在初诊时可能已出现广泛转移。蒽环类药物是治疗晚期血管肉瘤的一线药物,但在伴有严重动脉粥样硬化及狭窄的患者中或应慎用。此外,地舒单抗注射液可能对血管肉瘤的骨破坏起到一定的治疗效果。
This article reports a 57-year-old male patient who presented with pain in both toes and black spots on the skin of the feet.One month later,angiosarcoma was diagnosed by the skin biopsy and pathological examination,with multiple bone metastases in the lumbar vertebrae,pelvis,and both lower limbs detected by ^(18)F-FDG PET-CT before.After receiving a single dose of epirubicin,the patient developed progressive gangrene of the left toes and the right great toe.CTA of bilateral lower limbs suggested stenosis of the abdominal aorta and bilateral common iliac arteries.Eventually,the patient underwent the abdominal aortic and bilateral common iliac arterial stent implantation,as well as the amputation of the left toes.The patient received monthly injections of denosumab,which showed modest effectiveness.Angiosarcoma is insidious in onset and progresses rapidly,with possibly extensive metastases at initial diagnosis.Anthracyclines are the first-line agents for angiosarcoma but should be used cautiously in patients with severe atherosclerosis and stenosis.Additionally,denosumab may have certain therapeutic effect on skeletal lesions in angiosarcoma.
作者
吴梦娇
范逸儿
张丽
章振林
WU Meng-jiao;FAN Yi-er;ZHANG Li;ZHANG Zhen-lin(Department of Endocrinology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China;Department of Osteoporosis and Bone Diseases,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University,Shanghai Clinical Research Center of Bone Disease,Shanghai 200233,China;Department of Pathology,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China)
出处
《中华骨质疏松和骨矿盐疾病杂志》
北大核心
2025年第2期198-207,共10页
Chinese Journal Of Osteoporosis And Bone Mineral Research
关键词
血管肉瘤
骨转移
化疗
坏疽
地舒单抗
angiosarcoma
bone metastasis
chemotherapy
gangrene
denosumab
