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一名晚期混合性生殖细胞肿瘤患者发生腹膜后淋巴结转移灶自发性破裂，导致大量出血。

Spontaneous rupture of a retroperitoneal lymph node metastasis causing massive hemorrhage in a patient with advanced mixed germ cell tumor.

作者信息

Filho Luiz Henrique Corrêa Portari, Silva Tiago Aparecido, Beal Pedro Rodrigues, Buonfiglio Vitor Bonadia, Sadi Marcus Vinicius

机构信息

Department of Surgery, Division of Urology, Federal University of São Paulo, Brazil.

出版信息

Urol Case Rep. 2022 Aug 4;45:102180. doi: 10.1016/j.eucr.2022.102180. eCollection 2022 Nov.

DOI:10.1016/j.eucr.2022.102180
PMID:35968525
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9372596/
Abstract

Retroperitoneal hemorrhage is a rare and life-threatening clinical presentation that may occur in patients with advanced germ cell tumors, typically after chemotherapy. Rapid clinical suspicion is crucial to offer the best treatment. Surgery is usually recommended but dismal complications may occur. We report on a man with metastatic testicular cancer presenting with massive spontaneous retroperitoneal hemorrhage that had not received previous systemic treatment and was managed without surgical treatment, with good clinical outcome.

摘要

腹膜后出血是一种罕见且危及生命的临床表现，可能发生在晚期生殖细胞肿瘤患者中，通常在化疗后出现。迅速的临床怀疑对于提供最佳治疗至关重要。通常建议进行手术，但可能会出现严重的并发症。我们报告了一名患有转移性睾丸癌的男性，出现大量自发性腹膜后出血，此前未接受过全身治疗，未进行手术治疗，临床结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/3e966af54851/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/c6f42ad7b937/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/9c53645bbd84/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/3e966af54851/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/c6f42ad7b937/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/9c53645bbd84/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bd2/9372596/3e966af54851/gr3.jpg

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本文引用的文献

1
Successful emergency endovascular aortic repair for intratumoral hemorrhage in extensive retroperitoneal mass of testicular origin.成功的急诊血管内主动脉修复术治疗源于睾丸的广泛腹膜后肿块的肿瘤内出血。
BMC Surg. 2020 Nov 7;20(1):272. doi: 10.1186/s12893-020-00933-2.
2
Recovery from Choriocarcinoma Syndrome Associated with a Metastatic Extragonadal Germ Cell Tumor Hemorrhage.与转移性性腺外生殖细胞肿瘤出血相关的绒毛膜癌综合征的康复。
Case Rep Gastroenterol. 2016 May 19;10(1):193-8. doi: 10.1159/000446017. eCollection 2016 Jan-Apr.
3
Massive hemorrhage from spontaneous rupture of a retroperitoneal lymph node in patient with metastatic mixed germ cell tumor.
患者患有转移性混合生殖细胞瘤，因腹膜后淋巴结自发性破裂导致大出血。
Urology. 2010 Jul;76(1):159-61. doi: 10.1016/j.urology.2009.10.001. Epub 2009 Nov 25.
4
Embolization for hemorrhage of liver metastases from choriocarcinoma.绒毛膜癌肝转移出血的栓塞治疗
Gynecol Oncol. 2005 Sep;98(3):506-9. doi: 10.1016/j.ygyno.2005.04.029.
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European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG).欧洲生殖细胞癌诊断与治疗共识：欧洲生殖细胞癌共识小组（EGCCCG）报告
Ann Oncol. 2004 Sep;15(9):1377-99. doi: 10.1093/annonc/mdh301.