Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.
Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.
复制标题
冷冻疗法治疗妇科癌症治疗后并发淋巴管瘤的大量外阴淋巴漏。
DOI：
10.1093/jjco/hyu125
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发表时间：
2014
期刊：
影响因子：
2.4
通讯作者：
Kobayashi H
中科院分区：
文献类型：
--
作者：
Yanazume S;Douzono H;Kubo H;Nagata T;Douchi T;Kobayashi H
外阴淋巴漏是妇科癌症治疗的严重并发症。然而，标准的治疗策略尚未确定。我们遇到一个罕见的情况下，一个76岁的经产妇患有大量的淋巴液泄漏从整个外阴，丘疹发展，并确定为淋巴管瘤。大量稻草色分泌物从外阴丘疹中持续出来，并延伸至阴阜。9年前，患者接受了根治性子宫切除术，同时进行了宫颈癌放化疗。她的血清白蛋白水平为1.9 mg/dl，这是由于外阴渗漏导致大量淋巴液流失所致。她的生活质量逐渐下降，因为全身疲劳和需要频繁更换尿布每2小时。患者接受了使用液氮的冷冻疗法的微创治疗。她还接受了多模式治疗，包括静脉注射白蛋白、下肢按摩和强化康复。冷冻治疗每周一次，持续3个月。她的分泌物几乎停止，外阴淋巴管瘤减少，没有任何重大并发症。据我们所知，这是第一例报告大量淋巴漏并发外阴淋巴管瘤。此外，此病例可能是第一个成功治疗外阴淋巴漏的冷冻疗法，没有复发。冷冻疗法可能有潜力改善生活质量，作为一种微创治疗妇科癌症幸存者，没有严重并发症。
Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications.