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一名孤立性肺转移鼻咽癌幸存者的姑息性手术及潜在治愈轨迹

Palliative Surgery and Potential Curative Trajectory in a Nasopharyngeal Cancer Survivor With Isolated Lung Metastasis.

作者信息

Panuganti Achyuth, Kaul Pallvi, Kumar Rahul, Garg Pankaj K

机构信息

ENT and Head-Neck Surgery, MediCiti Institute of Medical Sciences, Secunderabad, IND.

Surgical Oncology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, IND.

出版信息

Cureus. 2024 Sep 11;16(9):e69196. doi: 10.7759/cureus.69196. eCollection 2024 Sep.

Abstract

The role of palliative surgery for excision of metastasis in a patient with nasopharyngeal carcinoma (NPC) is limited. However, judicious patient selection can yield noteworthy long-term survival outcomes. We report a case of the occurrence of isolated lung metastasis and its management in a NPC survivor with a long disease-free interval. The patient underwent radiotherapy and chemotherapy in 2014 for primary NPC cT2N1M0. In November 2019, he presented with a cough and respiratory distress. The investigation unveiled an isolated lung metastasis that partially encased the left upper lobe bronchus and closely abutted the left main bronchus and left pulmonary artery. Following comprehensive multidisciplinary consultations involving the patient and relatives, the patient underwent a left pneumonectomy as an imperative palliative intervention to alleviate the symptomatic respiratory distress and long-term disease control. Remarkably, the patient's disease-free status has persisted post surgery until 2024, evoking consideration of a potential curative trajectory. This case emphasises comprehensive evaluations, multidisciplinary discussions, and individualised treatment plans. It encourages patients to remain optimistic and engaged in their healthcare journey.

摘要

姑息性手术在鼻咽癌(NPC)患者中用于切除转移灶的作用有限。然而,明智地选择患者可产生值得注意的长期生存结果。我们报告一例在无病间期较长的NPC幸存者中发生孤立性肺转移及其治疗的病例。该患者于2014年因原发性NPC cT2N1M0接受了放疗和化疗。2019年11月,他出现咳嗽和呼吸窘迫。检查发现一个孤立性肺转移灶,该转移灶部分包绕左肺上叶支气管,并紧邻左主支气管和左肺动脉。在与患者及其亲属进行全面的多学科会诊后,患者接受了左肺切除术,作为一项必要的姑息性干预措施,以缓解有症状的呼吸窘迫并实现长期疾病控制。值得注意的是,患者术后一直处于无病状态,直至2024年,这引发了对潜在治愈轨迹的思考。该病例强调了全面评估、多学科讨论和个体化治疗方案。它鼓励患者保持乐观并积极参与其医疗过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fae8/11469339/b08e6215b0e1/cureus-0016-00000069196-i01.jpg

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