使用丝裂霉素C进行腹腔热灌注化疗后阴囊壁坏死：病例报告及文献复习
Scrotal wall necrosis after hipec using mitomycin-c: Case report and review of the literature.
作者信息
El Halabieh Mriam Attalla, Lodoli Claudio, Ferracci Federica, Santullo Francesco, Pacelli Fabio, Foschi Nazario
机构信息
Surgical Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Italy.
Surgical Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Italy.
出版信息
Int J Surg Case Rep. 2025 Jan;126:110797. doi: 10.1016/j.ijscr.2024.110797. Epub 2025 Jan 1.
INTRODUCTION
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a current treatment option for peritoneal carcinosis (PC) after cytoreductive surgery (CRS). Genital skin alterations are rare complications reported variously after HIPEC using Mitomycin-C.
PRESENTATION OF CASE
A 42-year-old man with a diagnosis of stage IV colorectal cancer underwent CRS and HIPEC using mitomycin-C. On postoperative day 75, he developed scrotal wall necrosis not responding to any medical treatment. After he underwent surgery to remove the necrotic tissue and primarily suture the scrotal wound with success.
DISCUSSION
Genital skins disorders are rarely drugs-related effects and few cases after HIPEC using Mitomycin-C are reported in literature. The most accepted hypothesis to explain the occurrence of scrotal ulcers after CRS and HIPEC is the extravasation reaction to Mitomycin-C that inhibits wound healing and induces skin necrosis.
CONCLUSION
Correct diagnosis and immediate surgical debridement are the preferable management.
引言
热灌注化疗（HIPEC）是目前减瘤手术（CRS）后腹膜癌转移（PC）的一种治疗选择。使用丝裂霉素-C进行HIPEC治疗后，生殖器皮肤改变是罕见的并发症，已有多种相关报道。
病例介绍
一名42岁诊断为IV期结直肠癌的男性接受了CRS及使用丝裂霉素-C的HIPEC治疗。术后第75天，他出现阴囊壁坏死，任何药物治疗均无效。之后他接受了手术，成功切除坏死组织并一期缝合阴囊伤口。
讨论
生殖器皮肤疾病很少是药物相关效应，文献中报道的使用丝裂霉素-C进行HIPEC治疗后的病例很少。解释CRS和HIPEC后阴囊溃疡发生的最被认可的假说是丝裂霉素-C的外渗反应，它会抑制伤口愈合并导致皮肤坏死。
结论
正确诊断和立即手术清创是较好的处理方法。
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