Tanaka Emi, Oda Naohiro, Ogawa Tsuneyoshi, Takata Ichiro, Terao Masako, Ueki Toru
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Department of Internal Medicine, Fukuyama City Hospital, Japan.
Intern Med. 2025 Mar 15;64(6):887-891. doi: 10.2169/internalmedicine.3988-24. Epub 2024 Aug 8.
A 56-year-old man presented to our hospital with dyspnea on exertion for two months. Bilateral pleural effusions were found, and a close examination revealed a chylothorax, including adenocarcinoma. The primary tumor could not be identified by systemic examination. Therefore, the patient was diagnosed with cancer of unknown primary (CUP) presenting with chylothorax. Chemotherapy was administered for CUP, and thoracentesis, pleurodesis, ascites puncture, and nutritional therapy were performed for chylothorax and chylous ascites. Although drainage frequency and tumor marker levels (CA19-9, DUPAN-2, and Span-1) temporarily decreased, disease control deteriorated, and the patient died 12 months after the initial diagnosis.
一名56岁男性因劳力性呼吸困难两个月前来我院就诊。发现双侧胸腔积液，详细检查显示为乳糜胸，包括腺癌。通过全身检查未发现原发肿瘤。因此，该患者被诊断为以乳糜胸为表现的原发灶不明的癌症（CUP）。对CUP进行了化疗，并对乳糜胸和乳糜性腹水进行了胸腔穿刺、胸膜固定术、腹水穿刺及营养治疗。尽管引流频率和肿瘤标志物水平（CA19-9、DUPAN-2和Span-1）暂时下降，但疾病控制情况恶化，患者在初次诊断后12个月死亡。
