Liu Chao-Yu, Yen Chueh-Chuan, Su Kang-Cheng, Wu Yu-Chung
Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Clinical Respiratory Physiology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Thorac Cancer. 2013 May;4(2):207-211. doi: 10.1111/j.1759-7714.2012.00154.x.
Gorham's disease (GD) is rare and characterized by non-neoplastic lymphovascular proliferation and massive osteolysis. Its clinical course is usually protracted, but sometimes life threatening when vital structures are involved or when complicated with chylothorax. There is no optimal treatment guideline for GD complicated with chylothorax. Surgical ligation of thoracic duct, pleurectomy, pleurodesis, interferon-alpha-2b, and radiotherapy, are reported to manage chylothorax. We present the case of a 32-year-old man with Gorham's disease complicated by bilateral chylothorax, which was refractory to radiotherapy but remitted dramatically two weeks after interferon-alpha-2a therapy. The patient was free of relapse four months after discontinuing four-month interferon therapy. To date, only 11 cases (including ours) of GD with chylothorax have received interferon as single or salvage therapy, and 10 of them survived. Early intervention with interferon therapy can be considered as an effective treatment for GD complicated with bilateral chylothorax.
戈勒姆病(GD)较为罕见,其特征为非肿瘤性淋巴管增生和大规模骨质溶解。其临床病程通常较为迁延,但当重要结构受累或并发乳糜胸时,有时会危及生命。对于并发乳糜胸的戈勒姆病,尚无最佳治疗指南。据报道,胸导管手术结扎、胸膜切除术、胸膜固定术、干扰素-α-2b和放射治疗可用于治疗乳糜胸。我们报告了一例32岁男性戈勒姆病并发双侧乳糜胸的病例,该患者对放射治疗无效,但在接受干扰素-α-2a治疗两周后病情显著缓解。在停止为期四个月的干扰素治疗四个月后,患者未出现复发。迄今为止,仅有11例(包括我们的病例)并发乳糜胸的戈勒姆病患者接受了干扰素单一治疗或挽救治疗,其中10例存活。对于并发双侧乳糜胸的戈勒姆病,可考虑早期采用干扰素治疗作为一种有效的治疗方法。