Sun Yunxia, Li Xiaoli, Li Lijun, Liu Huan, Xu Qian, Liu Bei
Medical Department, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730000, P.R. China.
Department of Hematology, The First Affiliated Hospital, Lanzhou University, Lanzhou, Gansu 730000, P.R. China.
Oncol Lett. 2017 Dec;14(6):7425-7430. doi: 10.3892/ol.2017.7166. Epub 2017 Oct 10.
In the present study, a case of chronic myeloid leukemia (CML) with complete situs inversus in a 68-year-old female patient was reported. The patient presented with general weakness, abdominal distension and tenderness in the right hypochondrium. A chest X-ray revealed a right-sided heart. Ultrasonography revealed situs inversus totalis. A bone marrow smear demonstrated CML in the accelerated phase. Imatinib mesylate was subsequently administered; the patient stopped taking imatinib mesylate following discharge from the hospital. The patient presented with dizziness, fatigue, and abdominal distention and pain 1 year subsequently. A bone marrow smear demonstrated CML in the blast crisis phase; CML had progressed to acute myeloid leukemia (AML) M2a. The patient was treated with imatinib mesylate and cytarabine. After 5 days, the white blood cell count had decreased compared with that measured at the time of admission, and the previous relevant symptoms had disappeared. The patient succumbed to AML 3 months after discharge from the hospital. Situs inversus totalis is an uncommon congenital anomaly that often occurs concomitantly with other disorders. The present study documented, to the best of our knowledge, the second recorded case of CML in a patient with situs inversus totalis. Previous studies on the pathogenesis of situs inversus have suggested it is caused by embryonic cells failing to rotate normally during early embryonic development. Although there are case reports of situs inversus totalis in patients with cancer, there are few reports on the association between situs inversus totalis and cancer. The present study examined a case of CML with situs inversus totalis and assessed whether the latter may be associated with cancer.
在本研究中，报告了一例68岁女性慢性髓性白血病（CML）患者合并完全性内脏反位的病例。患者表现为全身乏力、腹胀及右季肋区压痛。胸部X线检查显示心脏在右侧。超声检查显示完全性内脏反位。骨髓涂片显示处于加速期的慢性髓性白血病。随后给予甲磺酸伊马替尼治疗；患者出院后停止服用甲磺酸伊马替尼。1年后患者出现头晕、乏力、腹胀及腹痛。骨髓涂片显示处于急变期的慢性髓性白血病；慢性髓性白血病已进展为急性髓系白血病（AML）M2a。患者接受甲磺酸伊马替尼和阿糖胞苷治疗。5天后白细胞计数较入院时下降，之前的相关症状消失。患者出院3个月后死于急性髓系白血病。完全性内脏反位是一种罕见的先天性异常，常与其他疾病同时发生。据我们所知，本研究记录了第二例完全性内脏反位患者发生慢性髓性白血病的病例。以往关于内脏反位发病机制的研究表明，它是由胚胎细胞在胚胎发育早期未能正常旋转所致。虽然有癌症患者发生完全性内脏反位的病例报告，但关于完全性内脏反位与癌症之间关联的报道很少。本研究检查了一例合并完全性内脏反位的慢性髓性白血病病例，并评估了后者是否可能与癌症有关。
