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晚期妊娠合并晚期乳腺伯基特淋巴瘤的多学科产前管理——病例报告及文献综述

Multidisciplinary Antenatal Management of a Late Pregnancy Complicated With Advanced Stage Breast Burkitt Lymphoma - Case Report and a Review of the Literature.

作者信息

Hua Zhong, Ijaz Iqra, Shahzad Muhammad N, Yi Duan, Hu Gao Y, Dong Fu X

机构信息

Department of Obstetrics, Luzhou Medical College Affiliated Hospital, Luzhou, CHN.

Sichuan Provincial Center for Gynecological and Breast Diseases, Southwest Medical University, Luzhou, CHN.

出版信息

Cureus. 2023 Feb 13;15(2):e34950. doi: 10.7759/cureus.34950. eCollection 2023 Feb.

Abstract

The multidisciplinary team (MDT) plays a pivotal role in establishing the diagnosis and tailoring treatment for challenging, complicated, rare obstetrical cases. At 28 weeks of gestation, a lady presented with an unresolved unilateral proptosis and sustained severe mastitis. MDT managed the patient at a tertiary care hospital for primary breast Burkitt lymphoma (PBBL). It is a rare and highly malignant condition requiring an aggressive therapeutic approach. Antenatal chemotherapy (ANC) with an aggressive regimen of R-hyper-CVAD/MA was started. A healthy baby was vaginally delivered after completing the second therapy cycle at 32+ weeks, weighing 1.6kg with a good Apgar score. Postnatally, the central nervous system (CNS) prophylaxis was added; after completing eight chemo cycles, our patient remained stabilized for nine months. Unfortunately, due to the refractory and aggressive nature of malignancy, it relapsed, giving an overall survival (OS) of two years. MDT care should be considered at the earliest possible period to expedite the entire process. Positive results can be achieved with timely aggressive treatment and early management of such cases.

摘要

多学科团队(MDT)在对具有挑战性、复杂性、罕见性的产科病例进行诊断和制定个性化治疗方案方面发挥着关键作用。妊娠28周时,一名女性出现未缓解的单侧眼球突出和持续性严重乳腺炎。多学科团队在一家三级护理医院对该患者进行了原发性乳腺伯基特淋巴瘤(PBBL)的治疗。这是一种罕见且高度恶性的疾病,需要积极的治疗方法。开始采用R-超CVAD/MA的积极方案进行产前化疗(ANC)。在32 +周完成第二个治疗周期后,通过阴道分娩出一个健康的婴儿,体重1.6千克,阿氏评分良好。产后,增加了中枢神经系统(CNS)预防措施;在完成八个化疗周期后,我们的患者病情稳定了九个月。不幸的是,由于恶性肿瘤的难治性和侵袭性,病情复发,总生存期(OS)为两年。应尽早考虑多学科团队护理,以加快整个治疗过程。对此类病例进行及时积极的治疗和早期管理可取得阳性结果。

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