Kostrzewska Magdalena, Nowak-Gabryel Michalina, Gabryel Marcin
Department of Pulmonology, Allergology and Pulmonary Oncology, Medical University of Poznań, Poland.
Pol Merkur Lekarski. 2011 Sep;31(183):171-4.
Lung cancer is the most common cause of cancer mortality in men and the fourth most common in women. The most frequent location of distant metastases are: the pleura, liver, suprarenal gland, brain, bones, pericardium and subcutaneous tissue. Others locations of distant metastases are very rare. This case report presents a 61-year-old female patient treated with Cisplatin and Vinorelbin therapy for posterior segment of eyeballs metastases secondary to NSCLS. Fluorescein angiography, computed tomography with contrast intensification and magnetic resonance were compared during the 3-month treatment period. After the 4-rd cycle of chemiotherapy (Cisplatin and Vinorelbin) one elevated choroidal mass on the posterior wall in the superiotemporal quadrant of the right eyeball and one mass in the lower-inside quadrant of the left eyeball had completely disappeared. The retina and a retinal pigment epithelial layer were flattened. Combining Cisplatin and Vinorelbin was optimal treatment for our patient with intraocular metastasis of NSCLC. The first clinical symptom of nonsmall cell lung cancer was blindness. The described case confirms, that distant metastases of non-small cell lung cancer also occur in atypical places at be a cause of great diagnostic problems and can delay start of anticancer treatment.
肺癌是男性癌症死亡的最常见原因，在女性中是第四大常见原因。远处转移最常见的部位是：胸膜、肝脏、肾上腺、脑、骨、心包和皮下组织。其他远处转移部位非常罕见。本病例报告介绍了一名61岁女性患者，因非小细胞肺癌继发眼球后段转移接受顺铂和长春瑞滨治疗。在3个月的治疗期间，对荧光素血管造影、增强计算机断层扫描和磁共振成像进行了比较。在第4周期化疗（顺铂和长春瑞滨）后，右眼球颞上象限后壁的一个脉络膜肿物和左眼球内下象限的一个肿物完全消失。视网膜和视网膜色素上皮层变平。对于我们这位患有非小细胞肺癌眼内转移的患者，联合使用顺铂和长春瑞滨是最佳治疗方案。非小细胞肺癌的首个临床症状是失明。所述病例证实，非小细胞肺癌的远处转移也发生在非典型部位，这会造成很大的诊断问题，并可能延迟抗癌治疗的开始。
