Yamamoto Akira, Imai Shigeki, Gyoten Masayuki, Kajihara Yasumasa
Dept. of Diagnostic Radiology, Kawasaki Medical School.
Gan To Kagaku Ryoho. 2002 Nov;29(11):1967-70.
A 70-year-old male complained of pain in the left neck. A tumor of about 8 cm in diameter was detected by contrast CT in the region extending from the anterior to upper mediastinum. For definitive diagnosis, biopsy was performed under CT guidance, and the patient was diagnosed as having anaplastic carcinoma in the thymus (T4, N1, M0, stage IVb). Since surgical treatment was judged to be impossible because of infiltration into large blood vessels, the patient underwent chemotherapy by intra-arterial injection (CDDP, ADM) and radiotherapy (45 Gy), and obtained a CR. Metastasis to the spleen was detected during the follow-up period, but a CR was obtained by chemotherapy by intra-arterial injection (CDDP) and systemic chemotherapy (TXL). Generally, the prognosis for carcinoma in the thymus is poor, and the prognosis for anaplastic carcinoma in the thymus is considered especially poor. However, chemotherapy by intra-arterial injection of carcinostatics such as CDDP can be applied to patients in whom surgical treatment is impossible.
一名70岁男性主诉左颈部疼痛。增强CT检查发现前上纵隔区域有一个直径约8厘米的肿瘤。为明确诊断,在CT引导下进行了活检,患者被诊断为胸腺未分化癌(T4,N1,M0,IVb期)。由于肿瘤浸润到大血管,判断无法进行手术治疗,于是患者接受了动脉内注射化疗(顺铂、阿霉素)和放疗(45 Gy),并获得完全缓解(CR)。随访期间发现脾脏转移,但通过动脉内注射化疗(顺铂)和全身化疗(多西他赛)再次获得完全缓解。一般来说,胸腺肿瘤的预后较差,胸腺未分化癌的预后尤其差。然而,对于无法进行手术治疗的患者,可以采用动脉内注射顺铂等抗癌药物进行化疗。