Baagar Khaled, Khan Fahmi Yousef, Alkuwari Einas
Department of Medicine, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.
Case Rep Oncol Med. 2013;2013:697251. doi: 10.1155/2013/697251. Epub 2013 May 29.
A 35-year-old Qatari man presented to our hospital with a 4-month history of mild abdominal pain, weight loss, and jaundice. He was found to have central intra-abdominal mass and a single testis in the scrotum. His investigations showed cholestatic jaundice and very high level of β -HCG (1131379 IU/L). CT scans of the chest and abdomen showed a huge pelvic-abdominal mass with extensive retroperitoneal lymphadenopathy, in addition to liver and lung metastases. CT-guided Tru-Cut biopsy of the mass showed mixed germ cell tumor. Chemotherapy was refused by the patient and his family. In the following days, the patient bled from his liver metastases leading to hemorrhagic shock, hemorrhage from metastatic sites of choriocarcinoma containing tumors is named choriocarcinoma syndrome. He was transferred to the medical intensive care unit, where he was intubated and resuscitated. Embolization of the right hepatic artery was done, but failed to control the bleeding, which continued with development of disseminated intravascular coagulopathy and a severe abdominal compartment syndrome, and eventually the patient died.
一名35岁的卡塔尔男子因持续4个月的轻度腹痛、体重减轻和黄疸症状前来我院就诊。检查发现他腹腔中部有肿块，阴囊内仅有一个睾丸。检查显示他患有胆汁淤积性黄疸，β-HCG水平极高（1131379 IU/L）。胸部和腹部的CT扫描显示，除了肝脏和肺部转移灶外，盆腔-腹部有一个巨大肿块，伴有广泛的腹膜后淋巴结肿大。CT引导下对肿块进行的粗针穿刺活检显示为混合性生殖细胞肿瘤。患者及其家属拒绝接受化疗。在接下来的几天里，患者因肝转移灶出血导致失血性休克，含有绒毛膜癌的肿瘤转移部位出血被称为绒毛膜癌综合征。他被转入医疗重症监护病房，在那里接受了插管和复苏治疗。对右肝动脉进行了栓塞，但未能控制出血，出血持续，并发展为弥散性血管内凝血和严重的腹腔间隔室综合征，最终患者死亡。
