Takagi Y, Nakamura H, Miwa K, Adachi Y, Fujioka S, Haruki T, Taniguchi Y
General Thoracic Surgery, Tottori University Hospital, Yonago, Japan.
Thorac Cardiovasc Surg. 2010 Aug;58(5):304-6. doi: 10.1055/s-0029-1240744. Epub 2010 Aug 2.
The patient was a 47-year-old male with the chief complaints of right shoulder pain and fever. A 10-cm mass was found to be present in the right pulmonary apical region on chest X-ray examination. The mass was diagnosed as a G-CSF-producing invasive apical cancer and the patient underwent chemoradiotherapy followed by right upper lobectomy with combined resection of the chest wall, and lymph node dissection. A very small nodule was noted in the right frontal lobe on brain MRI before surgery, and the final diagnosis was pT3N0M1, stage IV lung adenocarcinoma. For the brain metastasis, gamma knife treatment and chemotherapy were performed after surgery, and there was no recurrence during 16 months after surgery. The prognosis for G-CSF-producing lung cancer and invasive apical cancer is poor. This was a rare and difficult case of lung cancer showing both characteristics of lung cancer.
该患者为47岁男性，主要症状为右肩疼痛和发热。胸部X线检查发现右肺尖区有一个10厘米的肿块。该肿块被诊断为产生粒细胞集落刺激因子（G-CSF）的浸润性肺尖癌，患者接受了放化疗，随后行右上叶切除术并联合胸壁切除及淋巴结清扫术。术前脑部MRI检查发现右额叶有一个非常小的结节，最终诊断为pT3N0M1，IV期肺腺癌。对于脑转移，术后进行了伽玛刀治疗和化疗，术后16个月无复发。产生G-CSF的肺癌和浸润性肺尖癌预后较差。这是一例罕见且棘手的肺癌病例，兼具肺癌的两种特征。
