Gokel J M, Rjosk H K, Meister P, Stelter W J, Witte J
Cancer. 1977 Mar;39(3):1317-21. doi: 10.1002/1097-0142(197703)39:3<1317::aid-cncr2820390345>3.0.co;2-a.
A unique case of a metastasising choriocarcinoma, inadvertently transplanted to a man from a female cadaver kidney is reported. When the kidney was removed six days after transplantation, arterial blood vessel infiltration by chorio-carcinoma cells and high levels of human chorionic gonadotropin (HCG) in the serum of the recipient indicated an haematogenous dissemination of viable neoplastic cells. The immunosuppressive therapy was discontinued after removal of the graft and the HCG levels in the recipient gradually decreased over a periode of eight weeks, indicating a slow immunologic rejection of the tumor cells. The recipient committed suicide seven months after the transplantation had failed. No metastases were found at a legal autopsy. It seems advisable, whenever there is evidence that neoplastic cells might have been transfered by a homograft, to remove the graft and discontinue the immunosuppressive therapy. Neoplastic cells already disseminated can still be eliminated when the immunologic system is intact and not suppressed.
本文报告了一例罕见的转移性绒毛膜癌病例,该肿瘤意外地从女性尸体肾移植到一名男性体内。移植六天后切除肾脏时,发现动脉血管被绒毛膜癌细胞浸润,且受者血清中人绒毛膜促性腺激素(HCG)水平升高,提示有存活的肿瘤细胞发生血行播散。移植肾切除后停用免疫抑制治疗,受者体内的HCG水平在八周内逐渐下降,表明肿瘤细胞被缓慢免疫排斥。移植失败七个月后,受者自杀。法定尸检未发现转移灶。每当有证据表明肿瘤细胞可能通过同种移植转移时,似乎明智的做法是切除移植器官并停用免疫抑制治疗。当免疫系统完整且未受抑制时,已经播散的肿瘤细胞仍可被清除。