Oki A, Kadokura M, Nonaka M, Yamamoto S, Kataoka D, Takaba T
First Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
Kyobu Geka. 2002 Nov;55(12):1027-30.
A 40-year-old male was detected his right apical lung tumor by roentgenographic screening on January 1997, but he did not refer to a hospital since he had no symptom. He went a orthopedics because of his right chest, back, and arm pain on October 1997, and he received traction and physical therapy. He went roentgenographic screening again on January 1998 and he was pointed out that the tumor increased. He admitted our hospital. Biopsy using bronchofiberscopy revealed adenocarcinoma and induction radiotherapy (40 Gy) was performed. Right upper lobectomy with chest wall resection and lymph node dissection was performed under hook approach. This approach was useful to dissect the tumor from the invaded plexus brachialis. Postoperative radio-chemotherapy was added but the patient died 7-postoperative months because of multiple metastases. Early detection should be led to early starting of the therapy.
一名40岁男性于1997年1月通过X线筛查发现右肺尖部肿瘤，但因无症状未去医院就诊。1997年10月，他因右胸、背部和手臂疼痛前往骨科就诊，接受了牵引和物理治疗。1998年1月他再次进行X线筛查，发现肿瘤增大，遂入住我院。经纤维支气管镜活检显示为腺癌，并进行了诱导放疗（40 Gy）。在钩形入路下行右上叶切除、胸壁切除及淋巴结清扫术。该入路有助于从受侵的臂丛神经中分离肿瘤。术后追加放化疗，但患者术后7个月因多发转移死亡。早期发现应促使早期开始治疗。
