Awobajo Moyosore D, Vaporciyan Ara A, Lu Charles, Gandhi Saumil J
Thoracic Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Thoracic Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
BMJ Case Rep. 2020 Apr 22;13(4):e234779. doi: 10.1136/bcr-2020-234779.
A 69-year-old woman underwent routine screening with CT scan of the chest, which showed a new right upper lobe lesion. Interval increase in size of the right upper lobe nodule over 3 months, prompted a CT-guided biopsy of the lung that confirmed a diagnosis of malignant pulmonary spindle cell carcinoma (PSCC) with 90% programmed death ligand 1 expression. Positron emission tomography CT demonstrated localised stage IIA disease. Given histologically proven PSCC and the rapid growth of her tumour, curative radiation with stereotactic body radiation therapy (SBRT) to the right upper lobe primary tumour was planned as patient was deemed not to be a surgical candidate. Repeat imaging with a CT chest 2 months after SBRT demonstrated good local control of the primary disease in the right upper lobe despite rapidly advancing distant metastasis. The patient continues systemic therapy with pembrolizumab, to which she has shown good response.
一名69岁女性接受了胸部CT扫描常规筛查，结果显示右肺上叶出现一个新病灶。右肺上叶结节在3个月内大小出现间隔性增大，促使进行了CT引导下的肺活检，确诊为恶性肺梭形细胞癌（PSCC），程序性死亡配体1表达率为90%。正电子发射断层扫描CT显示为局部IIA期疾病。鉴于组织学证实为PSCC且肿瘤生长迅速，由于患者被认为不适合手术，计划对右肺上叶原发性肿瘤采用立体定向体部放射治疗（SBRT）进行根治性放疗。SBRT后2个月进行的胸部CT复查显示，尽管远处转移迅速进展，但右肺上叶原发性疾病仍得到了良好的局部控制。患者继续接受派姆单抗全身治疗，且已显示出良好疗效。
