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- W2313146572 abstract "精巣腫瘍の化学療法中に脳梗塞をきたした症例を経験したので文献的考察を加え報告する．31歳男性．半年前より右陰嚢の腫脹を自覚，増大したため近医を受診し高位除睾術施行．病理は混合型胚細胞腫 (絨毛上皮癌＞精上皮腫)，pT1|多発性肺転移を認め当科紹介．術後LDH 231IU/l (200～400IU/l)，AFP 1.9ng/ml (10ng/ml以下)，HCG 23,000mIU/ml (0.7mIU/ml以下)．International Germ Cell Consensus Classification (IGCCC) のintermediate riskとしてBEP療法開始．2コース目第11病日に軽度の意識障害 (JCS1) と左片麻痺が出現．MRIにて左中大脳動脈領域の梗塞巣を確認したため，ただちに治療を開始した．海外での報告では精巣癌患者の化学療法中に血栓塞栓症をきたした例は8.4％，脳梗塞については1.1％という報告があり，発生の危険因子がいくつか指摘されている．自験例では病状の回復を待ち3コース目を終了，肺転移巣の消失を確認し化学療法後3カ月現在，再発を認めていない．また，脳梗塞による麻痺症状はリハビリを施行して3カ月には右上肢はMMT2度，右下肢はMMT4度まで改善し自力歩行可能となっている． 化学療法中に神経学的異常を認めた時には若年者であっても脳血栓塞栓症を鑑別に入れ治療開始することが必要である．" @default.
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- W2313146572 date "2009-01-01" @default.
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- W2313146572 title "A CASE OF BRAIN INFARCTION DURING CISPLATIN-BASED COMBINED CHEMOTHERAPY WITH BLEOMYCIN, ETOPOSIDE AND CISPLATIN FOR TESTICULAR CANCER" @default.
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- W2313146572 doi "https://doi.org/10.5980/jpnjurol.100.12" @default.
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