Liu Na, Yang Lei, Long Yan, Jiang Guoqing
Department of Gynecology & Obstetrics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong'an Road, Beijing 100050, China.
Open Med (Wars). 2020 Oct 1;15(1):981-985. doi: 10.1515/med-2020-0118. eCollection 2020.
As the most effective treatment for end-stage renal diseases, renal transplantation can improve the quality of life of patients and prolong the survival time. However, during the prolonged survival time, malignancy has become one of the main causes of death of recipients, which vary geographically. Tumors in the digestive system and urothelial tumors have been highly reported in Asia. In general, the gynecological malignant tumors have been rarely reported, especially the endometrial carcinoma. Herein, a 63-year-old female renal transplant recipient diagnosed with endometrial carcinoma (15 years after transplantation) was reported. The patient had suffered irregular postmenopausal bleeding for a short time before hospitalization. She underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, right pelvic lymphadenectomy, right para-aortic lymphadenectomy and omental excision. Postoperative pathology showed ovarian and pelvic lymph node metastasis and pathological stage IIIC. After six courses of chemotherapy with paclitaxel 270 mg + carboplatin 500 mg, the patient's renal function was normal. During the third cycle of chemotherapy, the patient suffered a third-degree bone marrow suppression and returned to normal soon when treated with the recombinant human granulocyte stimulating factor. In conclusion, early screening of gynecologic tumors is important for female patients after renal transplantation, which has a positive significance for the prognosis improvement.
作为终末期肾病最有效的治疗方法，肾移植可以提高患者的生活质量并延长生存时间。然而，在延长的生存期间，恶性肿瘤已成为受者主要死亡原因之一，且存在地域差异。消化系统肿瘤和尿路上皮肿瘤在亚洲的报道较多。一般来说，妇科恶性肿瘤的报道很少，尤其是子宫内膜癌。在此，报告了一名63岁女性肾移植受者（移植后15年）被诊断为子宫内膜癌的病例。该患者在住院前短时间内出现绝经后不规则出血。她接受了腹式子宫切除术、双侧输卵管卵巢切除术、右盆腔淋巴结清扫术、右腹主动脉旁淋巴结清扫术和大网膜切除术。术后病理显示有卵巢和盆腔淋巴结转移，病理分期为IIIC期。在接受六个疗程的紫杉醇270mg + 卡铂500mg化疗后，患者肾功能正常。在化疗第三个周期时，患者出现三度骨髓抑制，经重组人粒细胞刺激因子治疗后很快恢复正常。总之，对肾移植术后女性患者进行妇科肿瘤早期筛查很重要，这对改善预后具有积极意义。
