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同一肺叶内原发性同步性小细胞肺癌和非小细胞肺癌:一例报告

Primary synchronous small and non-small cell lung cancer in the same lung lobe: A case report.

作者信息

Dzian Anton, Ivan Fúčela, Zdenko Huťka, Peter Szépe

机构信息

Comenius University, Jessenius Faculty of Medicine in Martin.

出版信息

Monaldi Arch Chest Dis. 2017 Dec 14;87(3):797. doi: 10.4081/monaldi.2017.797.

Abstract

Synchronous multiple primary lung cancer (SMPLC) means tumours present at the same time, which are separate and have different histology. We present the case of a 66-year-old patient with a combination of small-cell lung carcinoma (SCLC) with adenocarcinoma in the same lobe with metastasis of SCLC in the mediastinal lymph node. This is a rare case. We performed a standard left upper video-assisted thoracoscopic lobectomy with mediastinal lymphadenectomy and adjuvant therapy targeted to SCLC was administered. Despite advances in imaging methods and diagnostic procedures in pneumology a diagnosis of SMPLC is often discovered only intraoperatively or accidentally during the histological examination. Actually, no guidelines exist for the treatment protocol of such cases. Multiple methods of management of SMPLC, mainly complete anatomical resection with lymphadenectomy combined with chemotherapy or radiotherapy should be adopted according to the histologic types, staging and molecular testing of the tumours. These rare cases of SMPLC require individual treatment and multidisciplinary approach.

摘要

同步性多原发性肺癌(SMPLC)是指同时出现的肿瘤,这些肿瘤相互独立且组织学类型不同。我们报告了一例66岁患者,其同一肺叶内同时存在小细胞肺癌(SCLC)和腺癌,且SCLC发生了纵隔淋巴结转移。这是一例罕见病例。我们进行了标准的左上肺电视辅助胸腔镜肺叶切除术及纵隔淋巴结清扫术,并给予了针对SCLC的辅助治疗。尽管肺部疾病的影像学方法和诊断程序有所进步,但SMPLC的诊断往往仅在术中或组织学检查时偶然发现。实际上,对于此类病例的治疗方案尚无指南可循。SMPLC的治疗方法多样,主要应根据肿瘤的组织学类型、分期和分子检测结果,采用完整的解剖性切除联合淋巴结清扫术,并结合化疗或放疗。这些罕见的SMPLC病例需要个体化治疗和多学科方法。

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