Stashower M E, Rennie T A, Turiansky G W, Gilliland W R
Department of Dermatology, National Naval Medical Center, Bethesda, Maryland, USA.
J Am Acad Dermatol. 1999 Feb;40(2 Pt 2):287-9. doi: 10.1016/s0190-9622(99)70466-4.
We describe a 53-year-old woman with a 4-month history of palpable purpuric papules on the upper and lower extremities. Biopsy of the skin lesions revealed leukocytoclastic vasculitis. Although she denied any systemic symptoms, urinalysis demonstrated hematuria and proteinuria. Although the patient's skin lesions responded to prednisone, her urinalysis did not improve. A 10-cm complex mass involving the left ovary and adnexa was incidentally discovered on renal ultrasound. Serum CA-125, an ovarian cancer marker, was elevated. Laparotomy revealed ovarian carcinoma confined to the left ovary. After the cancer was resected, the patient's urinalysis slowly improved. Leukocytoclastic vasculitis (LCV) is infrequently associated with underlying malignancy and only rarely with solid tumors. We postulate that the patient's vasculitis represented a paraneoplastic phenomenon that allowed a diagnosis of asymptomatic ovarian carcinoma. To our knowledge, this is the first report of LCV occurring as the presenting sign of ovarian cancer.
我们描述了一位53岁女性，其上下肢出现可触及的紫癜性丘疹已有4个月病史。皮肤病变活检显示白细胞破碎性血管炎。尽管她否认有任何全身症状，但尿液分析显示有血尿和蛋白尿。尽管患者的皮肤病变对泼尼松有反应，但其尿液分析并未改善。肾脏超声偶然发现一个10厘米的复杂肿块，累及左卵巢和附件。血清CA - 125（一种卵巢癌标志物）升高。剖腹手术显示卵巢癌局限于左卵巢。癌症切除后，患者的尿液分析逐渐改善。白细胞破碎性血管炎（LCV）很少与潜在恶性肿瘤相关，与实体瘤相关的情况更为罕见。我们推测患者的血管炎代表一种副肿瘤现象，从而得以诊断出无症状卵巢癌。据我们所知，这是首例以LCV作为卵巢癌首发体征的报告。
