Kourda Nadia, Bettaïeb Ilhem, Blel Ahlem, Zoghlami Ayoub, Bedoui Riadh, Najah Nabil, Ben Jilani Sarrah Baltagi, Zermani Rachida
Departement of Pathology, Charles Nicolle's hospital, Tunis, Tunisia.
Tunis Med. 2009 May;87(5):359-61.
A rare case of colonic carcinoma arising in de novo ulcerative colitis after renal transplantation in a 42-year-old woman is reported.
Clinically, the patient presented ulcerative colitis 8 years after renal transplantation, developed colonic cancer with liver metastasis 2 years later and died one month post operatively. Histologically, the removed tumor was composed of two distinctive elements consisting of adenocarcinoma and choriocarcinoma. The metastatic foci in the liver were composed exclusively of choriocarcinoma. Identification as choriocarcinoma was made on the basis of typical histological appearance, immunohistochemical demonstration of human chorionic gonadotropin (hCG) in the tumor cells and the high serum hCG level, unrelated to trophoblastic disease. In this report, pathogenesis is briefly discussed and clinical conditions are reviewed.
In conclusion, the issue of de novo UC after organ transplantation is still a matter of debate. Further investigations are necessary to understand the tumorogenesis of colorectal cancer in de novo UC after renal transplantation,
报告一例42岁女性肾移植后新发溃疡性结肠炎继发结肠癌的罕见病例。
临床上,该患者肾移植8年后出现溃疡性结肠炎,2年后发生结肠癌伴肝转移,术后1个月死亡。组织学上,切除的肿瘤由腺癌和绒毛膜癌两种不同成分组成。肝脏转移灶仅由绒毛膜癌组成。根据典型的组织学表现、肿瘤细胞中人绒毛膜促性腺激素(hCG)的免疫组化证实以及与滋养层疾病无关的高血清hCG水平,确诊为绒毛膜癌。本报告简要讨论了发病机制并回顾了临床情况。
总之,器官移植后新发溃疡性结肠炎的问题仍存在争议。有必要进一步研究以了解肾移植后新发溃疡性结肠炎中结直肠癌的肿瘤发生情况。