Objective To observe an early result after the repair of the large upper thoracic wall defect by a combined use of the titaniumnet, reconstruction nickelclad, and latissimus dorsi myocutaneous flap in a patient who underwent a breast sarcomatoid caricinoma resection on the upper thoracic wall. Methods A breast sarcomatoid carcinoma in the upper thoracic wall was removed in 1 56yearold female patient in February 2006. After the tumorectomy, a large thoracic wall defect was left, which was 20cm×15cm in size. The defect was covered by the titanium net, the bilateral stumps of the clavicles were connected by the reconstruction nickelclad, and the soft tissue defect was repaired with the right latissimus dorsi myocutaneous flap(20cm×15cm). Results The patient depended on the breathing machine for 3 days after operation. When the breathing machine was discontinued, the patient developed a severe paradoxical breathing. Two weeks after operation when theblood circulation of the flap was stabilized, the paradoxical breathing disappeared with the help of the chest bandage for fixation of the chest cavity, and the blood supply of the flap was improved. The chest X-ray film showed that the titanium net and the reconstruction nickelclad were well positioned. The patient received chemotherapy 1 month after operation, The follow-up for 3 months revealed that the patient’s local condition and physical condition were good, and ROMof both the shoulders was improved, with AF 90° and ABD 90°. No recurrence ofthe tumor was found. Conclusion A large thoracic wall defect should be repaired with solid materials. The normal anatomic locations of the clavicles should be maintained with fixation by the reconstruction nickelclad for a good function of the shoulders. The latissimus dorsi myocutaneous flap can be properly enlarged.
【摘要】 目的 探討子宮腺肉瘤早期的臨床表現、影像學特征、組織病理學以及治療和預后。 方法 對2006年—2010年病理診斷為子宮腺肉瘤的4例青年女性患者進行回顧性分析。 結果 子宮腺肉瘤占同期子宮肉瘤的6.8％（4/58），患者平均發病年齡為40歲，均未絕經。患者均有陰道不規則流血，B型超聲示最大1例腫物直徑為11 cm，其余結節直徑平均約1.5 cm。1例患者的CA125水平高于正常。術后隨訪期間所有患者身體狀態良好，無復發。 結論 子宮腺肉瘤惡性程度較低，如能及時治療，預后較好。【Abstract】 Objective To investigate the clinical manifestations, imaging features, histopathology, treatment and prognosis of uterine adenosarcoma. Methods The clinical data of four young female patients with uterine adenosarcoma collected from 2006 to 2010 were analyzed retrospectively. Results Uterine adenosarcoma accounted for 6.8% in uterine sarcoma (4/58). All patients were not menopausal, with the average onset age of 40 years old. Abnormal vaginal bleeding were seen in all patients. The diameter of the largest nodule was 11 cm, and the average of the others was 1.5cm approximately in B-ultrasound image. The value of CA125 increased in one patient. During the follow-up period, all patients survived without tumor recurrence. Conclusion Uterine adenosarcoma is a low-grade malignancy. Timely treating may lead to a good prognosis.
