Kibe Y, Kishimoto S, Katoh N, Yasuno H, Yasumura T, Oka T
Department of Dermatology, Kyoto Prefectural University of Medicine, Japan.
Br J Dermatol. 1997 May;136(5):752-6.
A case of cutaneous angiosarcoma occurring in a 51-year-old male renal transplant patient is reported. Multiple violaceous nodules surrounded by poorly demarcated red to purple discoloration were found on his scalp. Immunosuppressants consisting of azathioprine and prednisolone had been administered during the 12-year period since the renal transplantation. We diagnosed the lesion clinically as a cutaneous angiosarcoma and performed a wide surgical excision. The histopathological findings confirmed the diagnosis and showed tumour cells in the peripheral margin. Postoperatively, the patient started immunotherapy with systemic administration of recombinant interleukin-2 (rIL-2), but he refused to continue it because of the acute rejection of the transplanted kidney induced by the rIL-2. Instead he received radiation therapy (total 7000 rad) of the scalp. Although no recurrence was noticed for 15 months after the completion of radiation, he died due to lung metastasis from angiosarcoma. We review the seven cases, including ours, of angiosarcoma after renal transplantation that are reported in detail in the literature.
报告了一例发生在一名51岁男性肾移植患者身上的皮肤血管肉瘤病例。在他的头皮上发现了多个紫罗兰色结节,周围有边界不清的红紫色变色区域。自肾移植后的12年期间,一直在使用由硫唑嘌呤和泼尼松龙组成的免疫抑制剂。我们临床诊断该病变为皮肤血管肉瘤,并进行了广泛的手术切除。组织病理学检查结果证实了诊断,并在周边边缘发现了肿瘤细胞。术后,患者开始接受重组白细胞介素-2(rIL-2)全身给药的免疫治疗,但由于rIL-2引起的移植肾急性排斥反应,他拒绝继续治疗。取而代之的是,他接受了头皮的放射治疗(总计7000拉德)。尽管放疗结束后15个月未发现复发,但他因血管肉瘤肺转移而死亡。我们回顾了文献中详细报道的包括我们病例在内的7例肾移植后血管肉瘤病例。