Takenaka Masaru, Ichiki Yoshinobu, Taira Akihiro, Shinohara Shinji, Kuwata Taiji, Hirai Ayako, Imanishi Naoko, Yoneda Kazue, Tsubota Noriaki, Tanaka Fumihiro
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Thoracic Surgery, Kita-Harima Medical Center, 926-250 Ichiba-cho, Ono City, Hyogo, 675-1392, Japan.
Gen Thorac Cardiovasc Surg. 2019 Oct;67(10):897-900. doi: 10.1007/s11748-019-01064-z. Epub 2019 Jan 12.
We report the case of a 56-year-old woman who underwent pleural biopsy to identify the cause of the right pleural effusion. The pathological diagnosis was epithelial malignant pleural mesothelioma. The patient worked as a junior high school teacher and strongly hoped for continuing work. Thus, we performed pleurectomy/decortication (P/D) as a curative surgery. The operative findings showed pleural thickening that in the lower lobe of the lung. Thus, peeling of the lower lobe was performed. Pleural biopsy was only performed on the upper and middle lobes. As a result, the operation was limited P/D. The pathological findings showed a small number of mesothelioma cells in the upper and middle lobes. The patient received four courses of cisplatin plus pemetrexed systemic chemotherapy after surgery. Continuous maintenance chemotherapy using pemetrexed has been performed until the time of writing. At present, she has continued her work for 6 years after the operation and has extended her retirement age without recurrence.
我们报告了一例56岁女性患者的病例，该患者接受了胸膜活检以确定右侧胸腔积液的病因。病理诊断为上皮型恶性胸膜间皮瘤。该患者为一名初中教师，强烈希望继续工作。因此，我们进行了胸膜切除术/剥脱术（P/D）作为根治性手术。手术所见显示肺下叶存在胸膜增厚。于是，对下叶进行了剥离。仅对上叶和中叶进行了胸膜活检。结果，该手术为局限性P/D。病理结果显示上叶和中叶有少量间皮瘤细胞。患者术后接受了四个疗程的顺铂加培美曲塞全身化疗。截至撰写本文时，一直在使用培美曲塞进行持续维持化疗。目前，她术后已继续工作6年，延长了退休年龄且无复发。
