Advanced Leiomyosarcoma of the Retroperitoneal Space in a Kidney Transplant Recipient with a History of Peritoneal Dialysis: A Case Report
| Autor: | Jacek Pająk, Aureliusz Kolonko, Jerzy Chudek, Anna Kozaczka, Olga Kaźmierczak, Maciej Kajor |
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| Rok vydání: | 2021 |
| Předmět: |
Leiomyosarcoma
Adult Epstein-Barr Virus Infections Herpesvirus 4 Human medicine.medical_specialty medicine.medical_treatment Case Reports Gastroenterology Peritoneal dialysis Positron Emission Tomography Computed Tomography Internal medicine medicine Humans Retroperitoneal space Retroperitoneal Space Kidney transplantation Trabectedin Retroperitoneal Leiomyosarcoma business.industry Immunosuppression Articles General Medicine medicine.disease Kidney Transplantation medicine.anatomical_structure Female Sarcoma business Peritoneal Dialysis medicine.drug |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| DOI: | 10.12659/ajcr.933267 |
| Popis: | Patient: Female, 44-year-old Final Diagnosis: Leiomyosarcoma • liver metastases Symptoms: Abdominal pain Medication:— Clinical Procedure: Biopsy Specialty: Nephrology • Oncology • Transplantology Objective: Rare disease Background: Leiomyosarcoma frequently occurs in patients who are on immunosuppressive therapy. It is the second most common sarcoma in this population and is often associated with Epstein-Barr virus (EBV) infection. We present a case of advanced leiomyosarcoma of the retroperitoneal space in a kidney transplant recipient and discuss additional risk factors for oncogenesis. Case Report: A 44-year-old woman with a history of peritoneal dialysis and kidney transplantation was diagnosed with multiple liver lesions. PET-CT scanning showed a metabolically active tumor in the left lumbar region with numerous liver focal lesions. The histological examination of the liver lesion biopsy identified advanced retroperito-neal leiomyosarcoma with a high proliferative index and liver involvement. Unexpectedly, the relation with EBV infection was not proven. The patient was treated with first-line doxorubicin, with the simultaneous reduction of immunosuppression. Owing to disease progression after 6 cycles, the patient received second-line chemo-therapy based on gemcitabine and docetaxel, which was terminated owing to unacceptable toxicity, despite an observed response. Third-line trabectedin-based therapy with good tolerance and stabilization of disease after 20 months was being maintained at the time of this report. Conclusions: The increased cancer mortality in solid-organ transplant recipients requires an individualized approach and increased post-transplantation screening according to additional specific cancer risk factors. A further consideration is the hypothetical relevance of long-term peritoneal membrane irritation in peritoneal dialysis patients. |
| Databáze: | OpenAIRE |
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