Chino Tatsunori, Oba Takaaki, Yamamoto Kana, Takekoshi Daiya, Iesato Asumi, Ito Tokiko, Kanai Toshiharu, Maeno Kazuma, Ito Kenichi
Division of Breast, Endocrine and Respiratory Surgery, Dept. of Surgery(II), Shinshu University School of Medicine.
Gan To Kagaku Ryoho. 2018 Dec;45(12):1771-1774.
A 61-year-old woman presented with metastatic breast cancer in her right lung 4 years and 11 months after the operation for her right breast cancer(HER2 enriched type). Chemotherapy(pertuzumab plus trastuzumab plus docetaxel)were ad- ministered. On day 2 of cycle 2, pegfilgrastim was administered because her neutrophils decreased to 54 cells/mL on day 8 of cycle 1. On day 9 of cycle 2, she developed left neck and chest pain. Moreover, she developed a fever of 39°C on day 14 and visited our hospital. Her WBC and CRP increased to 18,300 cells/mL and 25.48mg/dL, respectively. Computed tomography revealed an increased CT value of the panniculus, around the aorta and left pleural effusion. Ultrasonography of the neck showed a marginal hypoechoic area around the left carotid artery, which corresponded with the pain. Arteritis induced by PFG was suspected. The neck pain and fever almost completely improved 19 days later, and cycle 3 was performed 28 days after cycle 2. To our knowledge, the present case is the second report of arteritis that was suspected to be associated with PFG.
一名61岁女性在右乳癌(HER2富集型)手术后4年11个月出现右肺转移性乳腺癌。给予化疗(帕妥珠单抗加曲妥珠单抗加多西他赛)。在第2周期第2天,因第1周期第8天中性粒细胞降至54个/毫升而给予培非格司亭。在第2周期第9天,她出现左颈部和胸痛。此外,在第14天她发热至39°C并前来我院就诊。她的白细胞计数和C反应蛋白分别升至18300个/毫升和25.48毫克/分升。计算机断层扫描显示皮下组织、主动脉周围CT值升高及左侧胸腔积液。颈部超声显示左颈动脉周围有边缘性低回声区,与疼痛部位相符。怀疑是培非格司亭诱发的动脉炎。19天后颈部疼痛和发热几乎完全缓解,在第2周期28天后进行了第3周期化疗。据我们所知,本病例是怀疑与培非格司亭相关的动脉炎的第二例报道。