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食管癌肺空洞转移罕见病例:一例报告

Unusual case of cavitary lung metastasis of esophageal cancer: A case report.

作者信息

Tsuji Toshikatsu, Nishimura Akihiro, Tawara Hiroki, Kadoya Shinichi, Bando Hiroyuki, Tsunezuka Yoshio

机构信息

Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa, Ishikawa, 9208530, Japan.

Department of Thoracic Surgery, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa, Ishikawa, 9208530, Japan.

出版信息

Int J Surg Case Rep. 2021 Mar;80:105662. doi: 10.1016/j.ijscr.2021.105662. Epub 2021 Feb 18.

Abstract

INTRODUCTION AND IMPORTANCE

Cavitary lung metastases are rare. We experienced lung metastasis of esophageal cancer with a cavity, which is extremely rare.

CASE PRESENTATION

A 69-year-old female diagnosed with thoracic esophageal cancer underwent radical esophagectomy. Pathological diagnosis was T3N0M0-pStageII. Cavitary lesion appeared in the lower lobe of the right lung 12 months after surgery. We suspected an inflammatory change and followed up strictly. On Computed tomography (CT) image 18 months after surgery, the cavitary lesion slightly increased in size, showing wall thickening and fluid inside. Fluid collection disappeared after antibiotic treatment. The patient was followed for 4 weeks without antibiotics and fluid collection reappeared. Cavitary lesion resection for the purpose of diagnosis was planned because malignancy could not be excluded, although the readministration of antibiotics was also considered. Thoracoscopic partial resection of the right lower lobe of the lung was performed. Histopathological examination showed squamous cell carcinoma which was similar in morphology to esophageal cancer. The final diagnosis was lung metastasis of esophageal cancer.

CLINICAL DISCUSSION

Metastatic lung cancer with a cavity is rare, accounting for approximately 4% of all cases. Moreover, Lung metastasis of esophageal cancer with a cavity is extremely rare.

CONCLUSIONS

The specimen collection, including total biopsy, should be aggressively performed when diagnosing cavitary lung disease in patients with a history of neoplastic disease.

摘要

引言与重要性

肺空洞性转移瘤较为罕见。我们遇到了一例伴有空洞的食管癌肺转移病例,这极为罕见。

病例介绍

一名69岁女性被诊断为胸段食管癌,接受了根治性食管切除术。病理诊断为T3N0M0 - pII期。术后12个月,右肺下叶出现空洞性病变。我们怀疑是炎症改变并进行了严格随访。术后18个月的计算机断层扫描(CT)图像显示,空洞性病变大小略有增加,伴有壁增厚和内部积液。抗生素治疗后积液消失。患者在未使用抗生素的情况下随访4周,积液再次出现。尽管也考虑重新使用抗生素,但由于不能排除恶性肿瘤,故计划进行空洞性病变切除以明确诊断。实施了胸腔镜下右肺下叶部分切除术。组织病理学检查显示为鳞状细胞癌,其形态与食管癌相似。最终诊断为食管癌肺转移。

临床讨论

伴有空洞的转移性肺癌罕见,约占所有病例的4%。此外,伴有空洞的食管癌肺转移极为罕见。

结论

对于有肿瘤病史的患者诊断空洞性肺部疾病时,应积极进行包括全活检在内的标本采集。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b939/7907421/bd4d9cf40da0/gr1.jpg

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