Yanagisawa Asako, Hayama Noriko, Amano Hiroyuki, Nakamura Makoto, Hirano Satoshi, Nakamura Sukeyuki, Tabeta Hiroshi
Department of Respiratory Medicine, Funabashi Municipal Medical Center, Japan.
Department of Oncology Medicine, Funabashi Municipal Medical Center, Japan.
Intern Med. 2017 Dec 1;56(23):3211-3213. doi: 10.2169/internalmedicine.8214-16. Epub 2017 Oct 11.
An 86-year-old Japanese man was diagnosed with stage IV lung adenocarcinoma. The patient was treated with crizotinib after echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) rearrangement was detected from his pleural effusion. He subsequently developed abdominal pain and rebound tenderness in the right lower abdomen. Contrast-enhanced abdominal CT showed a low-density area in the abdominal cavity. The size of the abscess was decreased by drainage and the administration of antibiotics. Fistulography revealed a fistula from the rectum to the abscess, and a diagnosis of lower intestinal tract perforation with abscess formation was made. Crizotinib was discontinued and treatment with alectinib was initiated. The patient remains under treatment as an outpatient at our department without adverse effects.
一名86岁的日本男性被诊断为IV期肺腺癌。在从其胸腔积液中检测到棘皮动物微管相关蛋白样4（EML4）-间变性淋巴瘤激酶（ALK）重排后，该患者接受了克唑替尼治疗。随后，他出现腹痛，右下腹有反跳痛。腹部增强CT显示腹腔内有低密度区。通过引流和使用抗生素，脓肿大小减小。瘘管造影显示从直肠到脓肿有瘘管形成，诊断为下肠道穿孔并形成脓肿。停用克唑替尼，开始使用阿来替尼治疗。该患者仍在我院门诊接受治疗，未出现不良反应。
