Palliative Treatment of Classic Kaposi Sarcoma-A Case Report

典型卡波西氏肉瘤的緩和治療

洪敏翔(Min-Hsiang Hung) ； 林聿山(Yu-San Lin) ； 李健逢(Chien-Feng Li) ； 葉敬淳(Chin-Choon Yeh) ； 黃國峰(Kuo-Feng Huang)

《臺灣整形外科醫學會雜誌》 19卷2期 (2010/06) Pp. 145-151

https://doi.org/10.7096/TJTSPS.201006.0145

摘要

背景：
典型卡波西氏肉瘤為一罕見疾病，主要好發於地中海及中歐國家。通常進展緩慢，但是偶爾也會有快速的進展。腫瘤本身易復發且往往需要積極的治療手段。
目的：
長期追蹤典型卡波西氏肉瘤使用緩和治療的結果。
材料及方法：
48歲台灣男性，九年前發現右腳足背有綠豆般的小結節，腫瘤切除之後，證實為典型卡巴西氏肉瘤。雖然進行了放射治療，但是腫瘤依舊在一年多後復發。復發的腫瘤在雙腳上一個接著一個長出來。由於病人拒絕化學治療，我們在局部麻醉下，緩和性的切除來取代全身性的化學治療。
結果：
從2004年1月到2009年1月，這五年期間，病人一共切除了25個典型卡波西氏肉瘤。雖然病人目前仍有腫瘤復發的情形，但皆位於雙腳足部。根據理學檢查、腹部超音波及胸部X光的追蹤，並無發現遠端轉移及內臟器官的侵犯。因此針對目前復發的腫瘤，我們仍持續使用緩和性切除的方法。
結論：
典型卡波西氏肉瘤雖然為一個難治癒的疾病但通常進展緩慢，倘若病人拒絕或是不適合做積極性的治療，緩和性的切除或許為另一個考慮。然而此治療方式仍需要更進一步的評估及跟其他方法做長期存活率的比較。

並列摘要

Background:
Classic Kaposi sarcoma (CKS) is a rare disease and predominantly affects Mediterranean and Middle Eastern men. Though it has an indolent course, a rapid progressive evolution may occasionally develop. Tumor recurrence is a troublesome condition and aggressive treatments are often necessary.
Aim and Objectives:
To follow up the long term outcomes of palliative excision of tumor recurrence on the classic Kaposi sarcoma.
Materials and Methods:
A 48-year-old Taiwanese man noted a small and blackish green nodule over dorsal aspect of right foot about 9 years ago. He underwent excision of the nodule at other hospital. Classic Kaposi sarcoma was diagnosed and the surgical margin was positive. Though, the radiotherapy was undergone for him, recurrence developed. The recurrent tumors over bilateral foot grew one after another. Because the patient refused chemotherapy, we used palliative excision of recurrent tumors instead of systemic chemotherapy.
Results:
Between January 2004 and January 2009, twenty-five Kaposi sarcomas were excised. Although recurrent tumors still developed at present, they were all located at bilateral foot. There was no evidence of distant metastasis or visceral organ involvement based on physical examination, abdominal sonogram and chest X-ray. We keep performing palliative excisions for recurrent nodules under local anesthesia now.
Conclusion:
Classic Kaposi sarcoma is a hardly curable disease but has an indolent progression. Palliative excision may be considered as an alternative treatment for patients who refuse or are unfit for aggressive treatments. However, this palliative excision needs to be further evaluated and possibly compared with other treatment options in long term survival rate.

並列關鍵字

Classic Kaposi sarcoma ； palliative treatment ； excision