鼻咽癌(NPC)患者远处转移是预期寿命降低的原因之一,最常见的转移扩散到骨,肝脏,还有肺.肝癌是最常见的肝脏恶性肿瘤,是全球癌症死亡的最高原因之一,这可能是NPC转移的结果。此病例报告的目的是介绍一名因NPC转移而怀孕的肝癌患者。一名34岁的怀孕女性在妊娠24-25周时表现出胃灼热和难以忍受的疼痛放射到背部的主要抱怨。既往病史报告患者肝脏肿大。患者为G4P2A1,具有单个存活的宫内胎儿和活跃的胎儿运动。患者有NPC病史,并在入院前一个月接受了完整的放化疗。体格检查显示右腹上腹象限双侧啰音和可触及的弥漫性多发结节。实验室检查显示贫血,血小板减少症,阴性乙型肝炎表面抗原(HBsAg),和肝脏标志物升高。腹部超声检查结果显示肝脏有多个弥漫性结节。根据临床和影像学发现,该患者被诊断为转移性肝癌。住院期间,患者反复出现胸腔积液并怀疑转移。几天后,胎动停止,超声检查提示胎心率为阴性.在经历了数小时的呼吸窘迫后,病人第二天就过期了。该病例强调,由于化疗和放疗的潜在不良反应,应谨慎决定开始这些疗法,以避免对母亲和胎儿造成不良影响.
Distant metastasis in nasopharyngeal carcinoma (NPC) patients is one of the reasons for the decreased life expectancy with the most common metastasis spreads are to the bone, liver, and lung.
Hepatoma is the most frequent liver malignancy and is one of the highest causes of cancer death worldwide and this can be as a result of NPC metastasis. The aim of this
case report was to present a patient with
hepatoma in pregnancy as a result of NPC metastasis. A 34-year-old pregnant female at 24-25 weeks of gestation presented with a chief complaint of heartburn and unbearable pain radiating to the back. Previous medical history reported that the patient had a liver enlargement. The patient was G4P2A1 with a single living intrauterine fetus and active fetal movements. The patient has a history of NPC and received a completed chemoradiation one month prior to hospital admission. Physical examination showed bilateral rales and palpable diffuse multiple nodule masses in the upper right abdominal quadrant. Laboratory examination revealed anemia, thrombocytopenia, negative hepatitis B surface antigen (HBsAg), and elevated liver markers. Abdominal ultrasonography results showed multiple diffuse nodules in the liver. The patient was diagnosed with a metastatic
hepatoma based on the clinical and imaging findings. During hospitalization, the patient repeatedly experienced pleural effusion with suspicion metastases. A few days later, the fetal movements stopped and the ultrasonography indicated negative fetal heart rate. After experiencing respiratory distress for hours, the patient expired the day after. This
case highlights that due to the potential adverse effects of chemotherapy and radiotherapy, the initiation of these therapies should be carefully decided to avoid adverse effects to mother and fetus.