Department of Medical Oncology, Tohoku University Hospital, Sendai 980-8547, Japan.
Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
Curr Oncol. 2024 Mar 12;31(3):1477-1482. doi: 10.3390/curroncol31030112.
Chylous ascites is a rare form of ascites with high triglyceride content arising from the thoracoabdominal lymph nodes in the peritoneal cavity due to various benign or malignant etiologies, including pancreatic cancer. During cancer chemotherapy, the accumulation of ascites can lead to the deterioration of the patient's general condition, making chemotherapy administration difficult, and resulting in a poor prognosis. We encountered a rare case of chylous ascites complicated by advanced pancreatic cancer. The patient presented with a discrepancy between the shrinkage of the pancreatic cancer and the accumulation of ascites. Therefore, we were able to promptly diagnose chylous ascites by performing biochemical tests. The patient was treated with octreotide, reportedly effective in treating chylous ascites, which rapidly improved the chylous ascites and general condition of the patient, allowing the patient to continue chemotherapy for pancreatic cancer. Therefore, physicians should consider the possibility of chylous ascites when clinically unexplained ascites are observed in patients with advanced cancer. The investigation and treatment of chylous ascites should be initiated as soon as possible.
乳糜性腹水是一种罕见的腹水形式,其特征是由于各种良性或恶性病因,包括胰腺癌,导致胸腹部淋巴结中的甘油三酯含量较高而进入腹腔。在癌症化疗期间,腹水的积聚会导致患者一般状况恶化,使化疗难以进行,并导致预后不良。我们遇到了一例罕见的晚期胰腺癌合并乳糜性腹水的病例。患者的胰腺癌缩小与腹水积聚之间存在差异。因此,我们通过进行生化测试及时诊断出乳糜性腹水。该患者接受了奥曲肽治疗,奥曲肽据称对治疗乳糜性腹水有效,可迅速改善乳糜性腹水和患者的一般状况,使患者能够继续接受胰腺癌的化疗。因此,当临床上观察到晚期癌症患者出现不明原因的腹水时,医生应考虑乳糜性腹水的可能性。应尽快开始对乳糜性腹水进行调查和治疗。