Nakagawa K, Toshima T, Momono S, Sasaki Y, Furusawa A, Sato T
Department of Surgery, Sendai Red Cross Hospital, Japan.
Gan To Kagaku Ryoho. 1992 Nov;19(13):2259-61.
The patient was a 68-year-old woman with advanced breast cancer which had been treated by modified radical mastectomy two years and nine months earlier. After the surgery, tamoxifen citrate (TAM) was orally administered in addition to various types of chemotherapy. Because the patient complained of nausea and weight loss, medroxyprogesterone acetate (MPA) was orally administered instead of TAM. The patient complained of intense abdominal pain on the 35th day of administration. Laparotomy was then performed for her acute abdominal problem. Because necrosis from bleeding due to jejunal vein thrombosis was observed in the jejunum for about 15 cm, resection of the jejunum was carried out. Histological observation demonstrated thrombosis in the vein, and cellular infiltration around the thrombosis. The postoperative prognosis has been favorable and the postoperative course is now being monitored at our clinic (2 months after surgery). The patient has no complications such as diabetes mellitus or hypercholesterolemia. The thrombosis observed in the jejunal vein, which is a rare site for it on the 35th day of MPA administration was induced by MPA. Due attention must be paid to the formation of thrombosis when using MPA.
该患者为一名68岁女性，患有晚期乳腺癌，两年零九个月前接受了改良根治性乳房切除术。术后，除了进行各种化疗外，还口服了枸橼酸他莫昔芬（TAM）。由于患者出现恶心和体重减轻的症状，遂改为口服醋酸甲羟孕酮（MPA）替代TAM。在服用MPA第35天时，患者主诉剧烈腹痛。随后因急性腹部问题为她实施了剖腹手术。术中发现空肠约15厘米处因空肠静脉血栓形成而出血坏死，于是进行了空肠切除术。组织学观察显示静脉内有血栓形成，血栓周围有细胞浸润。术后预后良好，目前正在我们诊所进行术后随访（术后2个月）。患者无糖尿病或高胆固醇血症等并发症。在服用MPA第35天时，空肠静脉出现血栓形成，这是一个罕见部位，系由MPA诱发。使用MPA时必须充分注意血栓形成问题。
