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一例子宫颈癌心脏转移病例。

A case of cardiac metastasis from uterine cervical carcinoma.

作者信息

Okamoto Kazuhiro, Kusumoto Tomoyuki, Seki Noriko, Nakamura Keiichiro, Hiramatsu Yuji

机构信息

Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan.

出版信息

Case Rep Obstet Gynecol. 2015;2015:703424. doi: 10.1155/2015/703424. Epub 2015 Feb 24.

DOI:10.1155/2015/703424
PMID:25830052
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4355340/
Abstract

Cases of cardiac metastasis from uterine cervical carcinoma are rare. While they are occasionally found on autopsy, antemortem recognition is extremely rare. We confirmed a case of cardiac metastasis from cervical carcinoma antemortem, because we observed a decrease in platelet count during the course of treatment. The patient was a 27-year-old woman diagnosed with stage Ib1 uterine cervical carcinoma. Radical hysterectomy with pelvic lymphadenectomy was performed. Para-aortic lymph node metastasis was detected on positron emission tomography/computed tomography (PET-CT). Adjuvant chemotherapy was started, and most of the metastatic lesions disappeared. Pelvic lymph node recurrence was suspected on PET-CT during continued chemotherapy; therefore, treatment was shifted to radiation therapy. Tumor shrinkage was recognized, and the initial therapy was completed. A noticeable decrease in platelet count was recognized seven months after treatment. Multidetector CT was performed, and an intracardiac tumor was detected. The patient did not desire any further treatment. She died three weeks after the intracardiac tumor was confirmed. Few previous autopsy studies have reported cardiac metastasis from cervical carcinoma. Thus, it is necessary to consider the possibility of cardiac metastasis for patients diagnosed with terminal cervical carcinoma.

摘要

子宫颈癌发生心脏转移的病例罕见。虽然偶尔在尸检时发现，但生前确诊极为罕见。我们确诊了一例子宫颈癌心脏转移的生前病例，因为在治疗过程中我们观察到血小板计数下降。该患者为一名27岁女性，被诊断为Ib1期子宫颈癌。行根治性子宫切除术及盆腔淋巴结清扫术。正电子发射断层扫描/计算机断层扫描（PET-CT）检查发现腹主动脉旁淋巴结转移。开始辅助化疗，大部分转移灶消失。在继续化疗期间，PET-CT怀疑盆腔淋巴结复发；因此，治疗改为放射治疗。肿瘤缩小，初始治疗完成。治疗七个月后发现血小板计数明显下降。进行了多排CT检查，发现心脏内有肿瘤。患者不希望进一步治疗。在确诊心脏内肿瘤三周后死亡。以往很少有尸检研究报道子宫颈癌心脏转移。因此，对于诊断为晚期子宫颈癌的患者，有必要考虑心脏转移的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/25ac02c11f80/CRIOG2015-703424.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/a6f508307b42/CRIOG2015-703424.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/f133596ba058/CRIOG2015-703424.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/1692cfa0061b/CRIOG2015-703424.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/ca80bf608aa1/CRIOG2015-703424.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/2fc3c2cc9cb0/CRIOG2015-703424.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/25ac02c11f80/CRIOG2015-703424.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/a6f508307b42/CRIOG2015-703424.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/f133596ba058/CRIOG2015-703424.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/1692cfa0061b/CRIOG2015-703424.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/ca80bf608aa1/CRIOG2015-703424.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/2fc3c2cc9cb0/CRIOG2015-703424.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68e/4355340/25ac02c11f80/CRIOG2015-703424.006.jpg

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