胸膜间皮瘤相关小肠受累致回肠穿孔1例并文献复习
Ileal Perforation Caused by Pleural Mesothelioma-related Small Intestinal Involvement:A Case Report and Literature Review
摘要
Abstract
Pleural mesothelioma(PM)usually manifests as local intrathoracic invasion,and small intestinal in-volvement is rare.A 37-year-old man with initially diagnosed stage IV diffuse PM and no definite history of asbestos exposure or other specific occupational or environmental exposure except for long-term smoking was reported.After first-line treatment with Pemetrexed,Carboplatin and Bevacizumab,the disease remained stable.However,acute abdomen occurred during main-tenance therapy,and emergency surgery confirmed terminal ileal perforation.Postoperative pathology suggested PM-related ileal involvement/metastatic involvement,with a higher Ki-67 proliferation index than that of the primary lesion.Because only perforation repair rather than segmental bowel resection was performed,the available pathological material could not deter-mine whether full-thickness bowel-wall involvement was present or the direction of tumor invasion.Imaging findings,intra-operative findings and pathological results did not support primary peritoneal mesothelioma or direct contiguous invasion of the ileum by the diaphragmatic lesion;however,microscopic peritoneal dissemination with secondary bowel-wall involvement could not be completely excluded.The aim of this report,together with literature review,is to summarize the diagnostic chal-lenges,management strategies and clinical implications of PM-related small intestinal involvement.关键词
胸膜间皮瘤/小肠转移瘤/穿孔/贝伐珠单抗Key words
Pleural mesothelioma/Small intestinal metastasis/Perforation/Bevacizumab引用本文复制引用
王韵佳,柏玉举,申芳倩,李启莎,李信娟,杨华,刘璞玉,杨雪峰,张念杰,周建国..胸膜间皮瘤相关小肠受累致回肠穿孔1例并文献复习[J].中国肺癌杂志,2026,29(6):462-468,7.基金项目
This paper was supported by the grants from the Young Top-notch Scientific and Technological Talent Program of the Guizhou Provincial Department of Education(Qian Jiao Ji[2024]No.333,to Jianguo ZHOU),the General Program of Humanities and Social Sciences Research of the Ministry of Education of China(Youth Fund)(No.24C10661007,to Jianguo ZHOU),the Future Science and Technology Elite Talent Program of the"12345 Future Talent Training Plan"of Zunyi Medical University(No.ZYSE-2023-02,to Jianguo ZHOU)and the"Chunhui Plan"Cooperative Research Project of the Ministry of Education of China(No.HZKY20220231,to Jianguo ZHOU).本研究受贵州省教育厅青年科技拔尖人才项目(黔教技[2024]333号)、教育部人文社会科学研究一般项目(青年基金)(No.24C10661007)、遵义医科大学"12345未来人才培养计划"未来科技菁英人才项目(No.ZYSE-2023-02)及教育部"春晖计划"合作科研项目(No.HZKY20220231)资助 （Qian Jiao Ji[2024]No.333,to Jianguo ZHOU）
