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早期膀胱癌膀胱内卡介苗治疗后发生的霉菌性主动脉瘤。

Mycotic aortic aneurysms post-Intravesical BCG treatment for early-stage bladder carcinoma.

作者信息

Wadhwani Aman, Moore Randy D, Bakshi Darshan, Mirakhur Anirudh

机构信息

1Department of Radiology, University of Calgary, Calgary, AB Canada.

4Foothills Medical Centre, G29, 1403-29th street NW, Calgary, AB T2N 2T9 Canada.

出版信息

CVIR Endovasc. 2018;1(1):28. doi: 10.1186/s42155-018-0036-y. Epub 2018 Aug 22.

Abstract

BACKGROUND

Intravesicular Bacillus Calmette-Guérin (BCG) is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease. Serious side effects are relatively rare but are difficult to diagnose and are often overlooked. Vascular complications are particularly rare.

CASE PRESENTATION

We report two cases of mycotic aortic aneurysms secondary to BCG treatment, one managed with endovascular stent-graft placement and the other with open surgical repair. The present understanding of disseminated BCGosis, including a literature review, will be discussed.

CONCLUSION

The incidence of mycotic aneurysms from BCG treatment is rare and very few cases have been reported in the literature. These cases further expand the current knowledge on vascular complications related to BCG treatment. In the absence of formal guidelines, we recommend a multidisciplinary approach involving vascular surgery, diagnostic and interventional radiology, and infectious disease to manage these patients.

摘要

背景

膀胱内灌注卡介苗(BCG)是浅表性膀胱癌的一种有效辅助治疗方法,已被证明可延缓疾病的复发和进展。严重副作用相对罕见,但难以诊断且常被忽视。血管并发症尤为罕见。

病例报告

我们报告两例卡介苗治疗继发的霉菌性主动脉瘤病例,一例采用血管内支架植入治疗,另一例采用开放手术修复。将讨论目前对播散性卡介苗病的认识,包括文献综述。

结论

卡介苗治疗引起的霉菌性动脉瘤发病率罕见,文献报道的病例很少。这些病例进一步扩展了目前关于卡介苗治疗相关血管并发症的知识。在缺乏正式指南的情况下,我们建议采用多学科方法,包括血管外科、诊断和介入放射学以及传染病学来管理这些患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f20e/6966377/e40bcebbaff7/42155_2018_36_Fig1_HTML.jpg

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