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月经紊乱, 下肢浮肿, 急性肾损伤——罕见盆腔占位的"瘤栓事件"

高雪涵 狄潇 冯凤芝 周娜 周炜洵 李源 朱阿芳 贺蕾 乔逸 孙蒙清 江欣 陈跃鑫 郑月宏

高雪涵, 狄潇, 冯凤芝, 周娜, 周炜洵, 李源, 朱阿芳, 贺蕾, 乔逸, 孙蒙清, 江欣, 陈跃鑫, 郑月宏. 月经紊乱, 下肢浮肿, 急性肾损伤——罕见盆腔占位的'瘤栓事件'[J]. 协和医学杂志, 2022, 13(4): 693-701. doi: 10.12290/xhyxzz.2021-0640
引用本文: 高雪涵, 狄潇, 冯凤芝, 周娜, 周炜洵, 李源, 朱阿芳, 贺蕾, 乔逸, 孙蒙清, 江欣, 陈跃鑫, 郑月宏. 月经紊乱, 下肢浮肿, 急性肾损伤——罕见盆腔占位的"瘤栓事件"[J]. 协和医学杂志, 2022, 13(4): 693-701. doi: 10.12290/xhyxzz.2021-0640
GAO Xuehan, DI Xiao, FENG Fengzhi, ZHOU Na, ZHOU Weixun, LI Yuan, ZHU A'fang, HE Lei, QIAO Yi, SUN Mengqing, JIANG Xin, CHEN Yuexin, ZHENG Yuehong. Menstrual Disturbance, Edema of the Lower Limb and Acute Kidney Injury: A Rare Event of 'Tumor Embolism' in Malignant Pelvic Tumor[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(4): 693-701. doi: 10.12290/xhyxzz.2021-0640
Citation: GAO Xuehan, DI Xiao, FENG Fengzhi, ZHOU Na, ZHOU Weixun, LI Yuan, ZHU A'fang, HE Lei, QIAO Yi, SUN Mengqing, JIANG Xin, CHEN Yuexin, ZHENG Yuehong. Menstrual Disturbance, Edema of the Lower Limb and Acute Kidney Injury: A Rare Event of "Tumor Embolism" in Malignant Pelvic Tumor[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(4): 693-701. doi: 10.12290/xhyxzz.2021-0640

月经紊乱, 下肢浮肿, 急性肾损伤——罕见盆腔占位的"瘤栓事件"

doi: 10.12290/xhyxzz.2021-0640
基金项目: 

国家自然科学基金 82170516

北京市自然科学基金 M22028

详细信息
    通讯作者:

    陈跃鑫, E-mail:cyuexin2007@163.com

    郑月宏, E-mail:yuehongzheng@yahoo.com

  • 中图分类号: R737.3;R654.3;R713.4

Menstrual Disturbance, Edema of the Lower Limb and Acute Kidney Injury: A Rare Event of "Tumor Embolism" in Malignant Pelvic Tumor

Funds: 

National Natural Science Foundation of China 82170516

Natural Science Foundation of Beijing M22028

More Information
  • 摘要: 低级别子宫内膜间质肉瘤(low-grade endometrial stromal sarcoma, LG-ESS)是一种罕见的子宫恶性肿瘤, 在所有子宫恶性肿瘤中占比不足1%, 目前国内外尚无关于LG-ESS导致急性完全性下腔静脉阻塞的报道。2020年11月, 北京协和医院血管外科接诊1例LG-ESS患者, 临床表现为月经紊乱、右下肢凹陷性水肿、突发恶心、少尿、肌酐升高, 影像学提示下腔静脉完全性阻塞, 通过多学科协作共同决策, 采用分期手术联合内分泌治疗成功救治该患者, 其诊疗过程体现了多学科协作在疑难重症患者诊治中的重要作用。
    作者贡献:高雪涵负责病例随访、论文撰写及修改;狄潇负责病例资料收集、随访及论文修改;冯凤芝、李源、周娜、周炜洵、朱阿芳、贺蕾、乔逸、孙蒙清、江欣、狄潇和陈跃鑫为多学科协作团队成员,负责病情讨论及制订诊治策略,提供论文修改建议;陈跃鑫和郑月宏负责论文审核、修订及润色。
    利益冲突:所有作者均声明不存在利益冲突
  • 图  1  患者下腔静脉造影检查结果(2020-10-26)

    A.右髂总静脉充盈缺损(箭头);B.下腔静脉肾下右侧壁半圆形充盈缺损(箭头);C.肾上段下腔静脉放置滤器(箭头);D.术中抽吸物

    图  2  患者胸腹盆腔增强CT检查结果(2020-11-14)

    A.下腔静脉内占位(可见滤器,箭头);B.左肾静脉梗阻扩张,淤血改变(箭头);C.右肾静脉梗阻扩张,淤血改变,右肾积水(箭头);D.盆腔肿物(箭头);E.左侧生殖静脉迂曲增粗(箭头);F.右侧生殖静脉迂曲增粗(箭头)

    图  3  患者第一次手术取出的下腔静脉内肿物及滤器

    图  4  患者第一次手术后血肌酐水平变化折线图

    图  5  患者第二次手术切除的全子宫及双侧附件大体标本

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    [13] Alkady H, Abouramadan S, Nagy M, et al. Removal of an endometrioid stromal sarcoma from the inferior vena cava and right atrium[J]. Gen Thorac Cardiovasc Surg, 2019, 67: 324-327.
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出版历程
  • 收稿日期:  2021-09-07
  • 录用日期:  2021-12-07
  • 网络出版日期:  2022-06-22
  • 刊出日期:  2022-07-30

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