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晚期胃癌侵犯脾静脉患者经部分脾栓塞成功治疗血小板减少症:病例报告

Successful management of thrombocytopenia by partial splenic embolization in patients with advanced gastric cancer and invasion of the splenic vein: Case reports.

作者信息

Nakatsubo Ryosuke, Yamauchi Yoshiya, Hiraizumi Taisho, Naruse Fumi, Kanda Ryoya, Suzuki Yuka, Kakegawa Tatsuya, Kurosawa Takashi, Yoshimasu Yu, Saguchi Toru, Sofuni Atsushi, Itoi Takao

机构信息

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Department of Radiology, Tokyo Medical University, Tokyo, Japan.

出版信息

Medicine (Baltimore). 2021 Jul 16;100(28):e26651. doi: 10.1097/MD.0000000000026651.

Abstract

RATIONALE

Hypersplenism causes thrombocytopenia, which may lead to the reduction or discontinuation of chemotherapy. Partial splenic embolization (PSE) is an effective treatment for thrombocytopenia associated with hypersplenism. However, there have been no reports of patients with gastric cancer who have resumed and continued chemotherapy after PSE for splenic hypersplenism associated with tumor infiltration.Here, we report two cases in which we performed PSE for hypersplenism associated with gastric cancer that had invaded the splenic vein. Chemotherapy was continued in both cases.

PATIENT CONCERNS

Both patients developed thrombocytopenia with splenomegaly due to advanced gastric cancer that required discontinuation of chemotherapy.

DIAGNOSIS

Upper gastrointestinal endoscopy and computed tomography showed advanced gastric cancer with invasion of the splenic vein and splenomegaly. Both patients developed thrombocytopenia.

INTERVENTIONS

Patients were treated with PSE.

OUTCOMES

PSE produced an increase in thrombocyte count, and chemotherapy could be resumed.

LESSONS

PSE seems to be a useful treatment for thrombocytopenia with splenomegaly associated with advanced gastric cancer and may allow continuation of chemotherapy.

摘要

理论依据

脾功能亢进会导致血小板减少,这可能会导致化疗减量或中断。部分脾栓塞术(PSE)是治疗脾功能亢进相关血小板减少的有效方法。然而,尚无关于胃癌患者因肿瘤浸润引起的脾功能亢进接受PSE治疗后恢复并继续化疗的报道。在此,我们报告两例因胃癌侵犯脾静脉导致脾功能亢进而行PSE治疗的病例。两例患者均继续接受化疗。

患者情况

两名患者均因晚期胃癌出现血小板减少和脾肿大,需要中断化疗。

诊断

上消化道内镜检查和计算机断层扫描显示晚期胃癌侵犯脾静脉并伴有脾肿大。两名患者均出现血小板减少。

干预措施

患者接受了PSE治疗。

结果

PSE使血小板计数增加,化疗得以恢复。

经验教训

PSE似乎是治疗晚期胃癌相关脾肿大伴血小板减少的有效方法,可能有助于继续进行化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f619/8284730/42c5f69a7f8e/medi-100-e26651-g001.jpg

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