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顺铂为基础的化疗治疗转移性睾丸生殖细胞肿瘤时并发颈内动脉闭塞和中风。

Internal carotid artery occlusion and stroke as a complication of cisplatin-based chemotherapy for metastatic testicular germ cell tumour.

作者信息

Cerrud-Rodriguez Roberto Christian, Quinteros Maria Gabriela, Azam Mohammed

机构信息

SBH Health System, Internal Medicine, Bronx, New York, USA.

出版信息

BMJ Case Rep. 2017 Jun 18;2017:bcr-2017-220084. doi: 10.1136/bcr-2017-220084.

Abstract

Testicular tumours are the most common tumours in young men. Germ cell tumours (GCTs) account for 95% of all testicular cancers, and the non-seminomatous type (NSGCT) accounts for 50% of all GCTs. Cisplatin-based chemotherapy is curative in up to 90% of patients, but it is not without its inherent risks. Ischaemic stroke is a very uncommon, but severe complication of cisplatin-based chemotherapy. Strokes in young patients cause a disproportionately large economic impact by leaving victims disabled during their most productive years and strains the healthcare system with expensive hospital stays. We present a case of a young male patient with past medical history of metastatic NSGCT with the sudden onset of dysarthria, left hemiplegia and ipsilateral hemisensory loss 3 days after receiving cisplatin-based chemotherapy. Subsequent studies revealed a stroke involving the right middle cerebral artery territory secondary to an acute right internal carotid occlusion.

摘要

睾丸肿瘤是年轻男性中最常见的肿瘤。生殖细胞肿瘤(GCTs)占所有睾丸癌的95%,而非精原细胞瘤类型(NSGCT)占所有GCTs的50%。以顺铂为基础的化疗对高达90%的患者具有治愈性,但并非没有其固有的风险。缺血性中风是基于顺铂化疗非常罕见但严重的并发症。年轻患者的中风会因使受害者在其生产力最高的年份致残而造成不成比例的巨大经济影响,并因昂贵的住院治疗给医疗系统带来压力。我们报告一例年轻男性患者,既往有转移性NSGCT病史,在接受基于顺铂的化疗3天后突然出现构音障碍、左侧偏瘫和同侧偏身感觉丧失。随后的研究显示,由于急性右侧颈内动脉闭塞,中风累及右侧大脑中动脉区域。

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J Investig Med High Impact Case Rep. 2015 Jun 9;3(2):2324709615590198. doi: 10.1177/2324709615590198. eCollection 2015 Apr-Jun.
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Strokes in young adults: epidemiology and prevention.年轻成年人中的中风:流行病学与预防
Vasc Health Risk Manag. 2015 Feb 24;11:157-64. doi: 10.2147/VHRM.S53203. eCollection 2015.
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Cisplatin-associated occlusion of the internal carotid artery.
Onkologie. 2009 Dec;32(12):754-7. doi: 10.1159/000252798. Epub 2009 Nov 20.
8
[Ischemic stroke after chemotherapy with cisplatin, etoposide and bleomycin: case report].
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