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一例伴 Trousseau 综合征的胆囊癌经根治性切除术成功治疗。

A Case of Gallbladder Cancer with Trousseau Syndrome Successfully Treated Using Radical Resection.

机构信息

Department of Gastroenterological Surgery, Kochi Health Sciences Center.

Department of Radiology, Kochi Health Sciences Center.

出版信息

Acta Med Okayama. 2024 Apr;78(2):201-204. doi: 10.18926/AMO/66931.

Abstract

Trousseau syndrome is characterized by cancer-associated systemic thrombosis. We describe the first case of a successfully treated gallbladder adenocarcinoma accompanied by Trousseau syndrome. A 66-year-old woman presented with right hemiplegia. Magnetic resonance imaging identified multiple cerebral infarctions. Her serum carbohydrate antigen 19-9 and D-dimer levels were markedly elevated, and a gallbladder tumor was detected via abdominal computed tomography. Venous ultrasonography of the lower limbs revealed a deep venous thrombus in the right peroneal vein. These findings suggested that the brain infarctions were likely caused by Trousseau syndrome associated with her gallbladder cancer. Radical resection of the gallbladder tumor was performed. The resected gallbladder was filled with mucus and was pathologically diagnosed as an adenocarcinoma. Her postoperative course was uneventful, and she received a one-year course of adjuvant therapy with oral S-1. No cancer recurrence or thrombosis was noted 26 months postoperatively. Despite concurrent Trousseau syndrome, a radical cure of the primary tumor and thrombosis could be achieved with the appropriate treatment.

摘要

特鲁索综合征的特征是癌症相关的全身性血栓形成。我们描述了首例成功治疗的伴发特鲁索综合征的胆囊腺癌病例。一名 66 岁女性因右侧偏瘫就诊。磁共振成像发现多发脑梗死。她的血清糖链抗原 19-9 和 D-二聚体水平明显升高,腹部 CT 检查发现胆囊肿瘤。下肢静脉超声显示右侧腓静脉深部静脉血栓形成。这些发现提示脑梗死可能是由特鲁索综合征伴发的胆囊癌引起的。对胆囊肿瘤进行根治性切除术。切除的胆囊充满黏液,病理诊断为腺癌。她的术后过程顺利,接受了为期一年的 S-1 口服辅助治疗。术后 26 个月未发现癌症复发或血栓形成。尽管并发特鲁索综合征,但通过适当的治疗,可以实现对原发性肿瘤和血栓的根治。

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