Kaphan E, Eusebio A, Witjas T, Donnet A, Vacher-Coponat H, Figarella-Branger D, Ali Chérif A
Service de Neurologie, Hôpital de la Timone, Marseille.
Rev Neurol (Paris). 2003 Nov;159(11):1055-9.
Immunodeficient patients have an increased incidence of neoplasms, whether the immunodeficiency is due to genetic disorder, the acquired immunodeficiency syndrome (AIDS), or immunosuppressive therapy. Leiomyosarcoma (LMS) is a rare neoplasm, even if its incidence has increased because of AIDS. Less than fifteen cases were described after organ transplantation. An intracranial localization is exceptional (five cases in the literature) and was never described after organ transplantation, to our knowledge. Our present report focuses on a 45-year-old immunocompromised patient, who received immunosuppressive therapy for renal transplantation. He suffered from atypical peri-orbital headaches six months after transplantation and a mass involving the cavernous sinus was identified. Surgical biopsy was performed. Histologic examination revealed a LMS. Epstein-Barr virus was identified by quantitative polymerase chain reaction in the LMS. Immunosuppression was reduced, the patient received adriamycin and protontherapy was realized. He died two years after the transplantation because of tumor progression and kidney failure.
免疫缺陷患者患肿瘤的几率增加,无论免疫缺陷是由遗传疾病、获得性免疫缺陷综合征(艾滋病)还是免疫抑制治疗引起的。平滑肌肉瘤(LMS)是一种罕见的肿瘤,尽管由于艾滋病其发病率有所上升。器官移植后报道的病例少于15例。据我们所知,颅内定位的情况极为罕见(文献中有5例),且器官移植后从未有过相关描述。我们目前的报告聚焦于一名45岁的免疫功能低下患者,他因肾移植接受了免疫抑制治疗。移植后6个月,他出现非典型眶周头痛,随后发现一个累及海绵窦的肿块。进行了手术活检。组织学检查显示为平滑肌肉瘤。通过定量聚合酶链反应在平滑肌肉瘤中检测到爱泼斯坦-巴尔病毒。免疫抑制治疗强度降低,患者接受了阿霉素治疗并进行了质子治疗。移植两年后,他因肿瘤进展和肾衰竭死亡。