Noguchi Go, Ota Junichi, Ishigaki Hanako, Onuki Tatsuaki, Kato Yoshitake, Moriyama Masatoshi
The Department of Urology, Yokohama Municipal Citizen's Hospital.
Hinyokika Kiyo. 2013 Aug;59(8):545-9.
We report a case of drug-induced pneumomediastinum by bleomycin in testicular cancer, which is extremely rare ; to our knowledge, only 3 cases have been reported. A 28-year-old man presented with a left testicular mass. He underwent radical left inguinal orchiectomy that demonstrated a seminoma, pT3N0M0. Ten months after surgery, para-aortic lymph node metastasis appeared, and he received three cycles of bleomycin, etoposide and cisplatin (BEP) chemotherapy. On day 13 of the fourth course of BEP, he complained of snowball crepitation of the neck and computed tomography revealed subcutaneous emphysema, extensive mediastinal air, and intraspinal air accumulation without pneumothorax. The pneumomediastinum and subcutaneous emphysema tended to deteriorate until 15 days after the onset of pneumomediastinum, but fortunately he had no signs or symptoms of infection. These findings resolved spontaneously after 1 month.
我们报告了一例睾丸癌患者因博来霉素导致药物性纵隔气肿的病例，这极为罕见；据我们所知，仅报告过3例。一名28岁男性出现左侧睾丸肿块。他接受了根治性左侧腹股沟睾丸切除术，术后病理显示为精原细胞瘤，pT3N0M0。术后十个月，出现主动脉旁淋巴结转移，随后他接受了三个周期的博来霉素、依托泊苷和顺铂（BEP）化疗。在BEP第四个疗程的第13天，他主诉颈部有握雪感捻发音，计算机断层扫描显示皮下气肿、广泛的纵隔积气和椎管内积气，无气胸。纵隔气肿和皮下气肿在纵隔气肿发作后15天内有加重趋势，但幸运的是他没有感染的迹象或症状。这些表现1个月后自行消退。
