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一名子宫内膜腺癌患者出现恶性黑棘皮病和掌跖角化病——病例报告及文献复习

Malignant acanthosis nigricans and tripe palms in a patient with endometrial adenocarcinoma--a case report and review of literature.

作者信息

Gorisek B, Krajnc I, Rems D, Kuhelj J

机构信息

Gynecology and Perinatology Clinic, Maribor Teaching Hospital, Ljubljanska, Slovenia.

出版信息

Gynecol Oncol. 1997 Jun;65(3):539-42. doi: 10.1006/gyno.1997.4674.

Abstract

BACKGROUND

In the world literature, uterine carcinoma associated with paraneoplastic malignant acanthosis nigricans and tripe palms has been mentioned in two review articles. Endometrial adenocarcinoma associated with malignant acanthosis nigricans without tripe palms has been cited in three case reports, and endometrial adenocarcinoma associated with tripe palms without malignant acanthosis nigricans has been cited in one case report. We present the case of a patient with endometrial adenocarcinoma associated with acanthosis nigricans and tripe palms which we have been following for the past 7 years.

METHODS

Our 54-year-old patient had been operated for moderately differentiated endometrial adenocarcinoma. She had also received postoperative radiotherapy.

RESULTS

Three years after surgery, tripe palms and acanthosis nigricans with generalized pruritus occurred. After treatment with etretinate, the skin symptoms were somewhat mitigated while the pruritus persisted. Six years after gynecologic treatment, a solitary inguinal metastatic lymph node of endometrial carcinoma was detected. Following lymphadenectomy there was additional but not complete mitigation of skin symptoms including pruritus.

CONCLUSIONS

In clinical practice the association of malignant acanthosis nigricans and tripe palms with endometrial adenocarcinoma is found extremely rarely. Although the survival time of adenocarcinoma patients with malignant acanthosis nigricans is short, our patient has been treated and followed for more than 7 years.

摘要

背景

在世界文献中,两篇综述文章提到了子宫癌与副肿瘤性恶性黑棘皮病和掌跖角化病相关。三篇病例报告引用了与无掌跖角化病的恶性黑棘皮病相关的子宫内膜腺癌,一篇病例报告引用了与无恶性黑棘皮病的掌跖角化病相关的子宫内膜腺癌。我们报告了一名患有子宫内膜腺癌并伴有黑棘皮病和掌跖角化病的患者的病例,在过去7年里我们一直在跟踪观察。

方法

我们的54岁患者接受了中度分化子宫内膜腺癌手术。她还接受了术后放疗。

结果

术后三年,出现掌跖角化病和伴有全身瘙痒的黑棘皮病。在用依曲替酯治疗后,皮肤症状有所减轻,但瘙痒持续存在。妇科治疗六年之后,检测到一个孤立的子宫内膜癌腹股沟转移淋巴结。淋巴结切除术后,包括瘙痒在内的皮肤症状进一步减轻但未完全缓解。

结论

在临床实践中,恶性黑棘皮病和掌跖角化病与子宫内膜腺癌的关联极为罕见。尽管患有恶性黑棘皮病的腺癌患者生存时间较短,但我们的患者已接受治疗并随访了7年多。

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