Kumamoto Makiko, Hamada Kaoru, Ohbayashi Chiho, Tamaki Shinji, Muro Shigeo
Department of Respiratory Medicine, National Hospital Organization Nara Medical Center, Nara, JPN.
Department of Respiratory Medicine, Nara Medical University, Kashihara, JPN.
Cureus. 2023 Mar 1;15(3):e35659. doi: 10.7759/cureus.35659. eCollection 2023 Mar.
A 52-year-old woman with multifocal micronodular pneumocyte hyperplasia in bilateral lungs and multiple sclerotic bone lesions (SBLs) visited our hospital. Tuberous sclerosis complex (TSC) was suspected but did not meet the diagnostic criteria. Ten years later, at age 62, the patient developed ureteral cancer. Cisplatin-containing chemotherapy ameliorated ureteral tumor, concomitant with exacerbation of SBLs. It was difficult to distinguish whether the exacerbation of SBLs was due to exacerbation of TSC or bone metastasis of cancer. The administration of cisplatin made the diagnosis even more difficult because its molecular biological effects can exacerbate the complications of TSC.
一名52岁女性因双侧肺部多灶性微小结节性肺细胞增生和多处硬化性骨病变(SBLs)前来我院就诊。怀疑患有结节性硬化症复合体(TSC),但不符合诊断标准。十年后,患者62岁时患输尿管癌。含顺铂的化疗使输尿管肿瘤得到缓解,但同时SBLs病情加重。很难区分SBLs病情加重是由于TSC病情加重还是癌症骨转移。顺铂的使用使诊断更加困难,因为其分子生物学效应会加重TSC的并发症。