Bestari M Begawan, Agustanti N
Department of Internal Medicine, Faculty of Medicine, Padjadjaran University - Hasan Sadikin Hospital, Bandung, Indonesia.
Acta Med Indones. 2013 Jul;45(3):216-9.
We report a 67-year-old female patient, recently diagnosed to have non-small cell lung cancer (NSCLC). On first PET (positron emission tomography) examination in October 2009, no distant metastasis. Four months later, second PET examination was done, detecting pancreatic foci in the uncinate process and in the tail of the pancreas measuring 22 mm which were more likely to be metastatic rather than primary origin. The patient underwent chemotherapy and radiotherapy. After 1 month of follow up, jaundice was noticed. Laboratory exams and MRCP showed obstructive jaundice. ERCP was performed with biliary stenting for palliative treatment. Symptomatic metastatic lesions of the pancreas from carcinoma of the lung are extremely rare. Typically, the patients remain asymptomatic until their disease reaches a fairly advanced stage, and therapeutic options are then limited to palliative measures.
我们报告了一名67岁的女性患者，最近被诊断为非小细胞肺癌（NSCLC）。2009年10月首次进行正电子发射断层扫描（PET）检查时，未发现远处转移。四个月后，进行了第二次PET检查，发现胰腺钩突和胰尾有病灶，大小为22毫米，更可能是转移性而非原发性。该患者接受了化疗和放疗。随访1个月后，发现黄疸。实验室检查和磁共振胰胆管造影（MRCP）显示为梗阻性黄疸。进行了内镜逆行胰胆管造影（ERCP）并置入胆管支架进行姑息治疗。肺癌胰腺转移的症状性病变极为罕见。通常，患者在疾病发展到相当晚期之前仍无症状，此时治疗选择仅限于姑息措施。
