Murray J C, Hill R M, Hegemier S, Hurwitz R L
Texas Children's Cancer Center, Baylor College of Medicine, Houston, USA.
J Pediatr Hematol Oncol. 1996 May;18(2):241-3. doi: 10.1097/00043426-199605000-00033.
Oncogenesis has been associated with prenatal exposure to phenytoin, concomitant with or independent of the fetal hydantoin syndrome. The majority of reported cases have been embryonal tumors of neural crest origin and have occurred in the first 3 years of life.
We report a boy who was exposed to phenytoin throughout gestation and later developed T-lymphocyte lymphoblastic lymphoma, a previously unreported malignancy associated with in utero phenytoin exposure. Previously reported cases of neoplasia occurring after such exposure are tabulated.
The actual transplacental oncogenic potential of phenytoin and the epidemiology of this association are poorly understood. Phenytoin-induced alterations in lymphocyte-mediated immunosurveillance or oxidative metabolic clearance may be etiologic. Inquiry into prenatal phenytoin exposure should be done in any child who develops cancer, especially those who develop a rare tumor or present with a more common tumor at an unusually young age. Continued documentation of such cases will advance the understanding of phenytoin-associated transplacental oncogenesis.
肿瘤发生与产前接触苯妥英有关，与胎儿乙内酰脲综合征相关或无关。大多数报告病例为神经嵴起源的胚胎性肿瘤，且发生在生命的头3年。
我们报告一名在整个妊娠期接触苯妥英的男孩，其后来发展为T淋巴细胞母细胞淋巴瘤，这是一种先前未报道的与宫内接触苯妥英相关的恶性肿瘤。将先前报道的此类接触后发生肿瘤的病例制成表格。
苯妥英实际的经胎盘致癌潜能以及这种关联的流行病学情况了解甚少。苯妥英引起的淋巴细胞介导的免疫监视或氧化代谢清除改变可能是病因。对于任何患癌儿童，尤其是那些患罕见肿瘤或在异常年幼时患更常见肿瘤的儿童，都应询问其产前苯妥英接触情况。持续记录此类病例将增进对苯妥英相关经胎盘致癌作用的理解。
