Kawai Koji, Takaoka Ei-Ichiro, Naoi Makito, Mori Kensaku, Minami Manabu, Shimazui Toru, Akaza Hideyuki
Department of Urology, Institute of Clinical Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba-City, Ibaraki, Japan.
Jpn J Clin Oncol. 2006 Oct;36(10):665-7. doi: 10.1093/jjco/hyl078. Epub 2006 Aug 24.
A 26-year-old man was referred to our hospital for treatment of metastatic testicular cancer. The pathological diagnosis was choriocarcinoma with seminoma. Sequential computerized tomography examinations revealed rapidly progressing bulky liver metastases and a lung metastasis. Chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started on the day of admission. Subsequently, the patient suffered from tumour lysis syndrome (TLS) and massive haemorrhage at metastatic sites. The latter complication is also called choriocarcinoma syndrome. To our knowledge, this is the first case report of testicular cancer complicated with both critical conditions. Intensive care and radiological intervention barely prevented a fatal outcome. The urological oncologist should be aware of the potential complications TLS and choriocarcinoma syndrome in cases of rapidly progressive and high-volume choriocarcinoma.
一名26岁男性因转移性睾丸癌被转诊至我院接受治疗。病理诊断为绒毛膜癌伴精原细胞瘤。连续的计算机断层扫描检查显示肝脏转移灶迅速增大且出现肺部转移。入院当天开始使用博来霉素、依托泊苷和顺铂(BEP)进行化疗。随后,患者出现肿瘤溶解综合征(TLS)及转移部位大量出血。后一种并发症也称为绒毛膜癌综合征。据我们所知,这是首例睾丸癌合并这两种危急情况的病例报告。重症监护和放射介入治疗勉强避免了致命后果。泌尿外科肿瘤学家应意识到,对于快速进展且肿瘤负荷大的绒毛膜癌病例,存在TLS和绒毛膜癌综合征的潜在并发症。