纳武利尤单抗治疗复发性霍奇金淋巴瘤后青少年早发放射性诱导肉瘤
Early Radiation-Induced Sarcoma in an Adolescent Treated for Relapsed Hodgkin Lymphoma with Nivolumab.
机构信息
Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Center for Pediatric Oncology and Hematology, Vilnius University, 08406 Vilnius, Lithuania.
出版信息
Medicina (Kaunas). 2020 Mar 31;56(4):155. doi: 10.3390/medicina56040155.
Radiation-induced sarcoma (RIS) has been reported as a late secondary malignancy following radiotherapy for various types of cancer with a median latency of 10 years. We describe an early RIS that developed in an adolescent within three years of treatment (including PD-L1 check-point inhibitor Nivolumab) of a relapsed classic Hodgkin lymphoma (HL) and was diagnosed post-mortem. The patient died of the progressive RIS that was misleadingly assumed to be a resistant HL based on the positive PET/CT scan. Repetitive tumor biopsies are warranted in cases of aggressive and multi-drug resistant HL to validate imaging findings, ensure correct diagnosis and avoid overtreatment.
放疗后肉瘤（RIS）是一种在接受各种类型癌症放疗后发生的迟发性第二原发恶性肿瘤，潜伏期中位数为 10 年。我们描述了一例青少年 RIS，其在接受复发经典霍奇金淋巴瘤（HL）治疗（包括 PD-L1 检查点抑制剂 Nivolumab）后三年内发生，且在死后确诊。该患者死于进行性 RIS，正电子发射断层扫描（PET/CT）显示疾病进展，基于该检查结果，HL 被误诊为耐药，患者因此死亡。在侵袭性和多药耐药 HL 病例中，需要重复肿瘤活检以验证影像学发现，确保正确诊断，避免过度治疗。
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