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交叉病理:外阴癌合并坏死梭杆菌感染

Intersecting Pathologies: Vulvar Cancer Complicated by a Fusobacterium necrophorum Infection.

作者信息

Anderson Todd R, Carletto Emily, Barreto-Nadal Valeria, Langston Emily, Jones Michael

机构信息

Obstetrics and Gynecology, Campbell University School of Osteopathic Medicine, Lillington, USA.

Pediatrics, Campbell University School of Osteopathic Medicine, Fayetteville, USA.

出版信息

Cureus. 2024 Nov 11;16(11):e73420. doi: 10.7759/cureus.73420. eCollection 2024 Nov.

Abstract

Vulvar cancer represents a small minority of annual cancer cases in America. This malignancy affects more than the physical health of the patient. This malignancy also has a negative impact on women's psychological and sexual health. This case pertains to a 49-year-old woman (G1P1001) who presented with right groin pain, fever, and chills for three days. She reported experiencing vaginal bleeding during the intercourse and had been able to palpate a mass inside her vagina for the past five years. A pelvic exam revealed a 6 cm tender mass on the left vaginal wall, which was friable and hemorrhagic on palpation, along with associated lymphadenopathy. The patient was taken to the operating room where the exophytic mass and lymphadenopathy were biopsied. Necrotic lymph nodes were removed and sent for pathology. Pathology confirmed moderately differentiated squamous cell carcinoma of the vulva. The lymph node pathology report also indicated that the necrotic nodes were infected with . Given the extent of the tumor, it was deemed largely inoperable, and the patient was recommended local radiation therapy. The patient was diagnosed with stage III vulvar cancer. This case highlights the intersection of gynecology-oncology and infectious disease, with a never-before-documented bacterial infection in the context of vulvar cancer. has been previously associated with colorectal cancers, liver abscesses, and ovarian abscesses. Further ingestion is needed to understand the role of this pathogen in the development of vulvar cancer.

摘要

外阴癌在美国每年的癌症病例中占比很小。这种恶性肿瘤不仅影响患者的身体健康,还会对女性的心理和性健康产生负面影响。该病例涉及一名49岁女性(孕1产1,0次流产,1次足月产),她出现右腹股沟疼痛、发热和寒战三天。她报告在性交时出现阴道出血,并且在过去五年中能够摸到阴道内有一个肿块。盆腔检查发现左阴道壁有一个6厘米的压痛肿块,触诊时质地脆且有出血,伴有相关的淋巴结病。患者被送往手术室,对外生性肿块和淋巴结病进行活检。切除坏死淋巴结并送去做病理检查。病理证实为中度分化的外阴鳞状细胞癌。淋巴结病理报告还表明坏死淋巴结感染了……鉴于肿瘤的范围,认为基本上无法手术,建议患者进行局部放射治疗。该患者被诊断为III期外阴癌。这个病例突出了妇科肿瘤学和传染病学的交叉点,在外阴癌的背景下出现了一种以前从未有记录的细菌感染。……以前曾与结直肠癌、肝脓肿和卵巢脓肿有关。需要进一步研究以了解这种病原体在外阴癌发生发展中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a17d/11634569/6a6398db8f97/cureus-0016-00000073420-i01.jpg

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