PDF(Pubmed)
Abstract：
UNASSIGNED: Germ cell tumours (GCT) are the most common malignancy affecting young adult men. The introduction of cisplatin-based chemotherapy in recent decades has significantly changed the prognosis of these malignant tumours into highly curable cancer, even in the setting of advanced disease. However, in the last decade, the success of these chemotherapy regimens in curing GCTs has been slowed by a growing recognition of their important late toxicities, such as cardiovascular disease.
UNASSIGNED: We present the case of a 23-year-old male, recently diagnosed with a mixed non-seminomatous testicular germinal tumour, on stage IIIA (pT3 cN2 cM1a), with retroperitoneal adenopathies and pulmonary metastases. After performing a right inguinal orchiectomy, he started chemotherapy treatment with cisplatin + etoposide. Shortly after starting treatment, the patient presented an ST-elevation acute coronary syndrome. The cardiac catheterization revealed a non-occlusive thrombus in the middle segment of the right coronary artery. Intracoronary imaging techniques were used to study the arterial wall, which revealed the presence of atherosclerotic plaque that could have ruptured, with the consequent response of platelet aggregation and thrombus formation. Barely 7 months after this event, the patient was again admitted to hospital for pulmonary thromboembolism with pulmonary infarction.
UNASSIGNED: To date, there are two hypotheses linking the association between cisplatin-based chemotherapy and cardiovascular disease. The direct hypothesis argues for the presence of direct chemotherapy-induced vascular damage. The indirect hypothesis, on the other hand, is based on the induction and development of cardiovascular risk factors by chemotherapy. This cardiovascular toxicity of chemotherapy is aggravated by a cancer-induced proinflammatory and prothrombotic state.
UNASSIGNED: We present the case of a 23-year-old male, recently diagnosed with a mixed non-seminomatous testicular germinal tumour, on stage IIIA (pT3 cN2 cM1a), with retroperitoneal adenopathies and pulmonary metastases. After performing a right inguinal orchiectomy, he started chemotherapy treatment with cisplatin + etoposide. Shortly after starting treatment, the patient presented an ST-elevation acute coronary syndrome. The cardiac catheterization revealed a non-occlusive thrombus in the middle segment of the right coronary artery. Intracoronary imaging techniques were used to study the arterial wall, which revealed the presence of atherosclerotic plaque that could have ruptured, with the consequent response of platelet aggregation and thrombus formation. Barely 7 months after this event, the patient was again admitted to hospital for pulmonary thromboembolism with pulmonary infarction.
UNASSIGNED: To date, there are two hypotheses linking the association between cisplatin-based chemotherapy and cardiovascular disease. The direct hypothesis argues for the presence of direct chemotherapy-induced vascular damage. The indirect hypothesis, on the other hand, is based on the induction and development of cardiovascular risk factors by chemotherapy. This cardiovascular toxicity of chemotherapy is aggravated by a cancer-induced proinflammatory and prothrombotic state.
摘要：
生殖细胞肿瘤（GCT）是影响年轻成年男性的最常见恶性肿瘤。近几十年来，以顺铂为基础的化疗的引入已经显著改变了这些恶性肿瘤的预后，成为高度可治愈的癌症。即使在晚期疾病的背景下。然而,在过去的十年里，越来越多的人认识到这些化疗方案的重要晚期毒性，减缓了这些化疗方案治疗GCT的成功。比如心血管疾病。
■我们介绍一个23岁男性的案例,最近被诊断出患有混合性非精原细胞性睾丸生发肿瘤，在IIIA阶段（pT3cN2cM1a），腹膜后腺病和肺转移。在进行了右腹股沟睾丸切除术后，他开始用顺铂+依托泊苷进行化疗.开始治疗后不久，患者出现ST段抬高型急性冠脉综合征.心导管检查显示右冠状动脉中段有非闭塞性血栓。冠状动脉成像技术用于研究动脉壁，揭示了可能破裂的动脉粥样硬化斑块的存在，伴随血小板聚集和血栓形成的反应。在此事件发生后不到7个月，患者因肺血栓栓塞合并肺梗死再次入院.
■到目前为止，有两个假设将基于顺铂的化疗与心血管疾病之间的关联联系起来.直接假设认为存在直接化疗引起的血管损伤。间接假设，另一方面,是基于化疗对心血管危险因素的诱导和发展。化疗的这种心血管毒性因癌症诱导的促炎和血栓形成状态而加重。
■我们介绍一个23岁男性的案例,最近被诊断出患有混合性非精原细胞性睾丸生发肿瘤，在IIIA阶段（pT3cN2cM1a），腹膜后腺病和肺转移。在进行了右腹股沟睾丸切除术后，他开始用顺铂+依托泊苷进行化疗.开始治疗后不久，患者出现ST段抬高型急性冠脉综合征.心导管检查显示右冠状动脉中段有非闭塞性血栓。冠状动脉成像技术用于研究动脉壁，揭示了可能破裂的动脉粥样硬化斑块的存在，伴随血小板聚集和血栓形成的反应。在此事件发生后不到7个月，患者因肺血栓栓塞合并肺梗死再次入院.
■到目前为止，有两个假设将基于顺铂的化疗与心血管疾病之间的关联联系起来.直接假设认为存在直接化疗引起的血管损伤。间接假设，另一方面,是基于化疗对心血管危险因素的诱导和发展。化疗的这种心血管毒性因癌症诱导的促炎和血栓形成状态而加重。
