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食管癌患者术后肾病综合征缓解 1 例报告。

Patient with esophageal cancer showing remission of nephrotic syndrome after esophagectomy: report of a case.

机构信息

Department of Surgery, Ohta Nishinouchi Hospital, Nishinouchi 2-5-20, Kohriyama, Fukushima, 963-8558, Japan,

出版信息

Surg Today. 2013 Dec;43(12):1452-6. doi: 10.1007/s00595-012-0477-1. Epub 2013 Mar 6.

Abstract

A 73-year-old male patient was admitted to our hospital due to bilateral leg edema and proteinuria in April 2009. After admission, nephrotic syndrome (membranous nephropathy) was diagnosed. At that point, a cancer screening test was performed; however, no abnormalities were noted. Medical treatment with prednisolone and cyclosporine was started, which resulted in the temporary improvement of markers of laboratory data. The patient was re-examined in November of the same year, and esophageal cancer (squamous cell carcinoma, T2N0M0 Stage IIA according to the UICC TNM classification) was detected in the lower thoracic esophagus. Subtotal esophagectomy was performed via right thoracolaparotomy with two-field lymph node dissection. Although the patient's course was complicated by respiratory failure, he was discharged after 38 days. After performing esophagectomy, prompt amelioration of the nephrotic syndrome occurred, allowing the withdrawal of prednisolone and cyclosporine. There has been no recurrence of esophageal cancer or relapse of nephrotic syndrome during a period of 18 months after esophagectomy.

摘要

一位 73 岁男性患者因双侧下肢水肿和蛋白尿于 2009 年 4 月入院。入院后诊断为肾病综合征(膜性肾病)。当时进行了癌症筛查,但未发现异常。给予泼尼松龙和环孢素治疗,实验室数据标志物暂时得到改善。同年 11 月再次检查,发现下段食管鳞状细胞癌(根据 UICC TNM 分期为 T2N0M0 ⅡA 期)。行右胸腹联合经右胸入路食管次全切除术加两野淋巴结清扫术。患者术后虽并发呼吸衰竭,但 38 天后出院。行食管切除术治疗后,肾病综合征迅速缓解,停用泼尼松龙和环孢素。食管切除术后 18 个月,未发现食管癌复发或肾病综合征复发。

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