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宫颈癌患者接受卡铂和紫杉醇治疗后出现可逆性后部白质脑病综合征:病例报告

Reversible posterior leukoencephalopathy syndrome following carboplatin and paclitaxel in cervical cancer: Case report.

作者信息

Ouchane Karima, Bellefkih Fatima Zahra, Benchakroun Nadia, Bourhafour Mouna, Chekrine Tarik, Bouchbika Zineb, Jouhadi Hassan, Tawfiq Nezha, Sahraoui Souha

机构信息

Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco.

Radiation Oncology Department, Mohammed IV Cancer Treatment Center, Ibn Rochd Hospital University, Hassan II University, Casablanca, Morocco.

出版信息

SAGE Open Med Case Rep. 2024 May 28;12:2050313X241257444. doi: 10.1177/2050313X241257444. eCollection 2024.

Abstract

Posterior reversible leukoencephalopathy is a rare radio-clinical entity that has gained increasing recognition over the last two decades. It is associated with various etiologies: arterial hypertension, autoimmune diseases, chemotherapy, and immunosuppressive drugs. Several cases have already been reported following cancer therapy. Posterior reversible leukoencephalopathy is characterized by capital clinical signs (headache, seizures, confusional syndrome, and visual disorders) and radiological abnormalities (cerebral edema predominantly in the posterior regions). We report the case of a 38-year-old female patient diagnosed with posterior reversible leukoencephalopathy after receiving Carboplatin and Paclitaxel chemotherapy for recurrent cervical cancer, which was revealed by a generalized seizure. Brain magnetic resonance imaging showed T2 Flair hyper signals in the parieto-occipital regions. This complication is rare but is probably underdiagnosed due to a lack of awareness and limited hindsight. Rapid diagnosis is essential to prevent acute neurological complications, which can be life-threatening or functionally crippling regardless of neoplasia.

摘要

后部可逆性白质脑病是一种罕见的放射学-临床病症,在过去二十年中得到了越来越多的认识。它与多种病因相关:动脉高血压、自身免疫性疾病、化疗以及免疫抑制药物。在癌症治疗后已有多例病例报道。后部可逆性白质脑病的特征为典型的临床症状(头痛、癫痫发作、意识模糊综合征和视觉障碍)以及放射学异常(主要为后部区域的脑水肿)。我们报告了一例38岁女性患者,在接受卡铂和紫杉醇化疗治疗复发性宫颈癌后,因全身性癫痫发作被诊断为后部可逆性白质脑病。脑部磁共振成像显示顶枕部区域T2 Flair高信号。这种并发症很罕见,但可能由于认识不足和回顾性分析有限而未得到充分诊断。快速诊断对于预防急性神经并发症至关重要,无论是否存在肿瘤,这些并发症都可能危及生命或导致功能残废。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d094/11135113/38487bd46f57/10.1177_2050313X241257444-fig1.jpg

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