Department of Thoracic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
Department of Respiratory Medicine, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
Thorac Cancer. 2017 May;8(3):271-274. doi: 10.1111/1759-7714.12423. Epub 2017 Feb 27.
An 81-year-old female patient was admitted to our institute because of abnormal X-ray results. Chest computed tomography showed a 7.7 × 5.3 cm mass located in the left lower lobe and multiple swollen lymph nodes. 18F-fluorodeoxyglucose-positron emission tomography indicated high standard uptake values in the mass and swollen lymph nodes. The patient was diagnosed with stage cT3N2M0-IIIA squamous cell carcinoma. Although the patient had multiple lymph node metastases and severe obstructive pulmonary function, four cycles of platinum doublet chemotherapy were initially performed and no side effect greater than grade 3 was experienced. As the lung cancer was downstaged to ycT2aN0M0-IB and pulmonary function had improved, a bronchodilating preparation, an uneventful left lower lobectomy, and a lymphadenectomy were performed. The patient was discharged 39 days after surgery and exhibited good health for a year at pathological stage ypT1aN0M0-IA (Ef2).
一位 81 岁女性患者因 X 线结果异常而被收入我院。胸部计算机断层扫描显示左肺下叶有一个 7.7×5.3cm 的肿块和多个肿大的淋巴结。18F-氟脱氧葡萄糖正电子发射断层扫描显示肿块和肿大淋巴结的标准摄取值较高。患者被诊断为 cT3N2M0-IIIA 期鳞状细胞癌。尽管患者有多个淋巴结转移和严重的阻塞性肺功能,但仍首先进行了四个周期的铂类双联化疗,且未出现大于 3 级的不良反应。由于肺癌降期为 ycT2aN0M0-IB,且肺功能有所改善,因此进行了支气管扩张剂治疗、无并发症的左下肺叶切除术和淋巴结切除术。患者术后 39 天出院,在病理分期为 ypT1aN0M0-IA(Ef2)时健康状况良好,已持续 1 年。