Zehnder P, Jenni W, Brandner S, Stäubli M, Waespe W, Aeschlimann A
Rheuma- und Rehabilitationsklinik Zurzach.
Praxis (Bern 1994). 2000 Apr 27;89(18):776-84.
In 1991, a 67 year old patient, suffering from an adenocarcinoma of the colon, had to undergo hemicolectomy. In the five following years, isolated metastases developed in the liver and have been surgically removed. In 1997, acute mononeuritis multiplex appeared and nerve biopsy revealed vasculitis. There were no signs of inflammatory rheumatic illness, collagenosis, cryglobulinemia, infection or hypersensitivity to medication. We have therefore postulated a relation between the vasculitis and the malignancy. Tumorous relapse could however not be detected at that time. Under immunosuppressive therapy, the neurological deficiencies receded partially, though the carcinoma of the colon reappeared with systemic metastases in the wake of the vasculitis. Diagnostic measures and the relationship between malignancy and vasculitis are discussed.
1991年,一名67岁的结肠腺癌患者不得不接受半结肠切除术。在随后的五年里,肝脏出现了孤立性转移瘤,并已通过手术切除。1997年,患者出现急性多发性单神经炎,神经活检显示血管炎。没有炎症性风湿性疾病、胶原病、冷球蛋白血症、感染或药物过敏的迹象。因此,我们推测血管炎与恶性肿瘤之间存在关联。然而,当时未检测到肿瘤复发。在免疫抑制治疗下,神经功能缺损部分缓解,尽管在血管炎发作后结肠肿瘤再次出现并伴有全身转移。本文讨论了诊断措施以及恶性肿瘤与血管炎之间的关系。