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1例西妥昔单抗治疗期间复发结肠癌伴心绞痛和间质性肺炎并死于癌性淋巴管炎

[A case of recurrent colon cancer with angina pectoris and interstitial pneumonia during cetuximab therapy with death by carcinomatous lymphangiosis].

作者信息

Shibahara Hiroaki, Kuze Shingo, Kyokane Takanori, Takamizawa Junichi, Nakamura Hayato, Morikawa Syuji, Hayashi Eijiro, Kinoshita Mana, Baba Satoshi

机构信息

Dept. of Surgery, Fukuroi Municipal Hospital.

出版信息

Gan To Kagaku Ryoho. 2010 Nov;37(11):2193-8.

Abstract

The case was a man in his 60s with no past history of heart and lung. Chest tightness was felt during the first course of cetuximab therapy for recurrent colon cancer. He was diagnosed as having vasospastic angina, and administration of vasodilatation agents was done. After the therapy, no chest pain attack was seen. Chemotherapy was continued. After 3 courses, fever elevation, chest tightness and dyspnea were seen. Chest X-ray and CT revealed diffuse interstitial pneumonia in bilateral lung. Although steroid pulse therapy and intensive therapy with mandatory ventilation were performed, he died of respiratory failure. Pathological findings of autopsy revealed remarkable metastasis of cancer cells to the bilateral lungs accompanied chiefly with carcinomatous lymphangiosis. Furthermore, acute and subacute interstitial pneumonia with diffuse alveolar damage were seen in the background of the lungs. Cardiopulmonary disorder as well as skin disorder should be considered as possible adverse events of cetuximab therapy.

摘要

该病例为一名60多岁的男性,既往无心肺病史。在复发性结肠癌的首个西妥昔单抗疗程中出现胸闷。他被诊断为血管痉挛性心绞痛,并给予了血管扩张剂治疗。治疗后,未再出现胸痛发作。化疗继续进行。3个疗程后,出现发热、胸闷和呼吸困难。胸部X线和CT显示双肺弥漫性间质性肺炎。尽管进行了类固醇冲击治疗和强制通气强化治疗,但他最终死于呼吸衰竭。尸检病理结果显示癌细胞显著转移至双肺,主要伴有癌性淋巴管炎。此外,在肺部背景中可见急性和亚急性间质性肺炎伴弥漫性肺泡损伤。心肺疾病以及皮肤疾病应被视为西妥昔单抗治疗可能的不良事件。

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