Moriyama A, Murata I, Kuroda T, Yoshikawa I, Tabaru A, Ogami Y, Otsuki M
Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Fukuoka, Japan.
J Gastroenterol. 1995 Aug;30(4):512-6. doi: 10.1007/BF02347569.
A 64-year-old man complaining of anterior chest pain, weight loss, and neck tumors was found to have advanced gastric cancer with pleuritis carcinomatosa and multiple lymph node and bone metastases. The patient was treated with combination chemotherapy consisting of mitomycin C (MMC), tegafur (UFT), and lentinan, and then with MMC and 5-fluorouracil (5FU) instillation into the pleural spaces after pleural drainage. With these treatments, the primary tumors and cancerous ulcers of the stomach improved markedly, and the lymph node enlargement and pleural effusion disappeared completely. Afterwards pericardiac metastasis complicated by cardiac tamponade occurred, but repeated pericardiocentesis and administration of MMC into the pericardiac cavity effectively eliminated the effusion. These treatments appeared potentially useful for advanced gastric cancer with generalized metastases including pericardiac involvement. However, the patient died of cardiac tamponade with massive pericardiac bleeding, probably due to the repeated pericardiocentesis and/or the administration of anticancer drugs.
一名64岁男性，因前胸疼痛、体重减轻和颈部肿物就诊，被诊断为晚期胃癌伴癌性胸膜炎、多发淋巴结及骨转移。患者接受了丝裂霉素C（MMC）、替加氟（UFT）和香菇多糖联合化疗，随后在胸腔引流后向胸腔内灌注MMC和5-氟尿嘧啶（5FU）。通过这些治疗，胃原发性肿瘤和癌性溃疡明显改善，淋巴结肿大和胸腔积液完全消失。此后发生心包转移并伴有心脏压塞，但反复心包穿刺及向心包腔内注入MMC有效消除了积液。这些治疗对于包括心包受累在内的广泛转移的晚期胃癌可能有效。然而，患者死于心脏压塞伴大量心包出血，可能是由于反复心包穿刺和/或抗癌药物的应用。
