Ruiz-Morales JM, Dorantes-Heredia R, Darwich-Del Moral GA, kinney-Novelo IM, Green-Renner D

Language: Spanish
References: 8
Page: 73-76
PDF size: 237.42 Kb.

ABSTRACT

Background. Soft tissue sarcomas are relatively rare compared to other cancers, accounting for less than 1% of all malignancies. They can appear anywhere on the body, although most affect the extremities muscles, chest wall, mediastinum and retroperitoneum. They appear at any age, but predominantly in elderly patients. The diaphragm primary presentation is rare, reported only in isolated cases. We report the case of a patient with primary diaphragm epithelioid sarcoma metastatic to lungs. Clinical case. Forty-eight years old man with no previous medical history with important antecedents. In late 2010 with cough and fever not associated with infectious etiology. By thorax computerized tomography, it was documented a 10 x 8 cm right hemidiaphragm mass. Biopsy was consistent with epithelioid sarcoma, with immunohistochemical markers positive for vimentin and S -100. He not received adjuvant treatment, but follow up. With metastatic progression, palliative chemotherapy with ifosfamide and Adriamycin was started for 6 cycles. To progression, he received three cycles with Dacarbazine. In follow-up, chest computerized tomography showed progression, so he received gemcitabine and docetaxel, with little tolerance to treatment. It was changed to pazopanib for six months. Because new progression, it was decided a new chemotherapy regimen with gemcitabine, docetaxel and bevacizumab at fractionated doses. Currently, the patient remains with stable disease after four cycles of treatment. Conclusion. Metastatic diaphragm epithelioid sarcoma is a rare neoplasm with poor prognosis in short term.

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