Lejomiosarkom gornjih delova respiratornog trakta
Sažetak
Uvod. Lejomiosarkom je maligni tumor glatko-mišićnog tkiva i uglavnom je prisutan u gastrointestinalnom sistemu, materici i retroperitoneumu. Gornji delovi respiratornog trakta nisu uobičajena lokalizacija ovog tumora. Prikaz bolesnika. Bolesnica stara 53 godine je potražila pomoć lekara zbog zapušenog nosa i bola lica, koji su bili prisutni u prethodna tri meseca. Endoskopskim pregledom je otkrivena polipoidna masa koja je ispunjavala desnu nosnu šupljinu. Bolesnica je operisana. Tokom operacije je nađena velika tumorska masa koja je zauzimala zadnji deo desne nosne šupljine i pružala se u lumen epifarinksa i gornji deo orofarinksa. Promena je u potpunosti odstranjena, sa odgovarajućim zaštitnim rubom okolnog zdravog tkiva. Na histološkim presecima obojenim hematoksilin-eozinom uočeni su snopovi atipičnih vretenastih ćelija, sa prisutnim čestim mitozama i ćelijama bizarnog izgleda. Imunohistohemijskom analizom je dokazana pozitivnost na aktin glatkih mišićnih ćelija i h-kaldezmon i negativnost na S-100. Histološke i imunohistohemijske karakteristike tumora su odgovarale lejomiosarkomu. Bolesnica je redovno kontrolisana endoskopskim pregledom i kompjuterizovanom tomografijom i do sada je 53 meseca bila bez simptoma. Zaključak. Prema našim podacima, ovo je najduži period preživljavanja kod bolesnika sa lejomiosarkomom gornjih partija respiratornog trakta (od 1996. godine). Taj tumor nema jasan klinički tok i prognozu. Potrebna su dodatna istraživanja da bi se odredila najbolja kombinacija postojećih terapija, kao i potencijalne nove terapije, u cilju dužeg preživljavanja obolelih.
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