与卵巢未成熟畸胎瘤相关的副肿瘤性胆汁淤积症。
Paraneoplastic Cholestasis Associated With Ovarian Dysgerminoma.
机构信息
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
出版信息
Obstet Gynecol. 2015 Aug;126(2):431-434. doi: 10.1097/AOG.0000000000000699.
BACKGROUND
Paraneoplastic syndromes are disorders caused by cancer that are not a direct result of the cancer mass itself or metastases to the affected organ. Paraneoplastic cholestasis is described with lymphoma and renal cell carcinoma. Unlike ovarian carcinoma, paraneoplastic syndromes are rarely seen in dysgerminoma.
CASE
A 22-year-old woman presented with 3 days of jaundice and lower abdominal pain. Liver tests revealed marked cholestasis and high alkaline phosphatase and bilirubin levels. Imaging showed a normal-appearing liver, a large multiseptated ovarian cystic mass, ascites, and paraaortic lymphadenopathy. Debulking surgery found a dysgerminoma with metastasis to aortic lymph nodes. Hepatic dysfunction completely resolved within 4 weeks of surgery.
CONCLUSION
Paraneoplastic syndrome should be considered in the differential diagnosis for patients with ovarian malignancies who present with cholestasis.
背景
副肿瘤综合征是由癌症引起的疾病，不是癌症本身或转移到受影响器官的直接结果。副肿瘤性胆汁淤积症与淋巴瘤和肾细胞癌有关。与卵巢癌不同，副肿瘤综合征在生殖细胞瘤中很少见。
病例
一名 22 岁女性因黄疸和下腹痛 3 天就诊。肝功能检查显示明显的胆汁淤积和碱性磷酸酶和胆红素水平升高。影像学检查显示肝脏外观正常，有一个大的多房性卵巢囊性肿块、腹水和主动脉旁淋巴结肿大。肿瘤减灭术发现生殖细胞瘤伴主动脉淋巴结转移。术后 4 周内肝功能完全恢复正常。
结论
对于出现胆汁淤积的卵巢恶性肿瘤患者，应考虑副肿瘤综合征作为鉴别诊断。
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