以异常子宫出血为表现的急性淋巴细胞白血病髓外复发：一例报告
Extramedullary Relapse of Acute Lymphoblastic Leukemia Presenting as Abnormal Uterine Bleeding: A Case Report.
作者信息
Robillard Diana T, Kutny Matthew A, Chewning Joseph H, Arbuckle Janeen L
机构信息
Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
出版信息
J Pediatr Adolesc Gynecol. 2017 Jun;30(3):431-434. doi: 10.1016/j.jpag.2016.12.004. Epub 2017 Jan 4.
BACKGROUND
Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Relapse of ALL occurs in 15%-20% of patients, with 2%-6% occurring exclusively in extramedullary sites. Relapse of ALL in gynecologic organs is extremely rare.
CASE
We present a case of a 12-year-old girl with a history of ALL who was referred to the pediatric gynecology clinic with abnormal uterine bleeding. She was determined to have an extramedullary uterine relapse of her ALL.
SUMMARY AND CONCLUSION
Abnormal uterine bleeding in the setting of childhood malignancy is a frequent reason for consultation to pediatric and adolescent gynecology services. This bleeding is commonly attributed to thrombocytopenia due to bone marrow suppressive chemotherapeutic agents. However, as shown in this report, abnormal uterine bleeding might be a manifestation of an extramedullary relapse.
背景
急性淋巴细胞白血病（ALL）是儿童期最常见的恶性肿瘤。15%-20%的ALL患者会复发，其中2%-6%仅发生于髓外部位。ALL在妇科器官复发极为罕见。
病例
我们报告一例12岁患ALL的女孩，因子宫异常出血转诊至儿科妇科门诊。她被确诊为ALL的子宫髓外复发。
总结与结论
儿童恶性肿瘤患者出现子宫异常出血是儿科及青少年妇科门诊常见的会诊原因。这种出血通常归因于骨髓抑制性化疗药物导致的血小板减少。然而，如本报告所示，子宫异常出血可能是髓外复发的一种表现。
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