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KÜÇÜK HÜCRELİ AKCİĞER KANSERLİ BİR OLGUDA TEDAVİ SONRASI REKÜRRENS VE METAKRON TÜMÖR GELİŞMESİ

Year 2012, Volume: 26 Issue: 2, 129 - 135, 01.10.2012

Abstract

Akciğer Tüberküloz'u (TB ) ülkemizde önemli derecede morbitide ve mortaliteye neden olmaktadır. Mycobacterium tüberculosis complex'in infeksiyonu oldukça heterojendir. Farklı radyolojik görünümle karşımıza çıkan ve metastatik akciğer kanserini taklit eden akciğer TB olgusunun sunulması uygun görüldü. Elli dokuz yaşında erkek hasta nefes darlığı, göğüs ağrısı şikayeti ile başvurduğu merkezimizde çekilen PA akciğer grafisinde; bilateral multipl sayıda nodüler lezyonlar, üst zonlarda hiperlüsensi saptandı. Bilgisayarlı toraks tomografisinde; bilateral multipl sayıda, multisentrik özellikte lezyonlar ve büllöz amfizem görünümü mevcuttu. Biyokimyasal ve hematolojik laboratuar bulguları normal sınırlar içerisinde idi. Yapılan bronkoskopide bronşiyal sistem doğal olarak izlendi. Balgam ve bronş lavaj sıvısında ARB negatif olarak bulundu. Tüm vücut malignite taramalarında patoloji saptanmadı. Hastaya sağ mini torakotomi ile nodul eksizyonu yapıldı. Patoloji sonucu amfizem, interstisyel pnömoni bulguları ve kazeifiye granulomatöz hastalık olarak raporlandı. Radyografide yaygın nodüler lezyonları olan olguların ayırıcı tanısında granülomatöz hastalıklar mutlaka düşünülmeli, ülkemiz şartlarında akciğer TB'unun hala ilk sıralarda değerlendirilmesi gerektiği unutulmamalıdır.

References

  • Johnson, BE. Second lung cancers in
  • patients after treatment for an initial lung
  • cancer. J Natl Cancer Inst 1998; 90: 1335.
  • Li, X, Hemminki, K. Familial and second
  • lung cancers: a nation-wide epidemiologic
  • cancer. Lancet 2005; 366: 1385-96.
  • Antakli, T, Schaefer, RF, Rutherford, JE, et al. Second primary lung cancer. Ann Thorac Surg 1995; 59: 863-7.
  • Johnson BE, Cortazar P, Chute JP. Second lung cancers in patients successfully treated for lung cancer. Semin Oncol 1997; 24(4): 492-9.
  • Adebonojo, SA, Bowser AN, Moritz DM, Corcoran PC. The results of modern surgical therapy for multiple primary lung cancers Chest. 1999; 115(6): 1507-13.
  • Aziz, TM, Saad, RA, Glasser J, et al. The management of second primary lung cancers. A single centre experience in 15 years. Eur J Cardiothorac Surg 2002; 21: 527-33.
  • Matsui K, Sawa T, Suzuki H, Nakagawa K, Okamoto N, Tada T, Nagano T, Masuda N. Relapse of stage I small cell lung cancer ten or more years after the start of treatment. Jpn J Clin Oncol. 2006; 36(7): 457-61.
  • Saito Y, Hayakawa K, Mitsuhashi N, Nakajima N, Kato S, Nakazato Y, Niibe H. Late relapse of small cell lung cancer treated with radiation therapy alone--case report. Lung Cancer 1994; 10(5-6): 319-24.
  • Agra, Y, Pelayo, M, Sacristan, M, et al. Chemo- therapy versus best supportive care for extensive small cell lung cancer. Cochrane Database Syst Rev 2003 (4): CD001990.
  • Groen HJ, Fokkema E, Biesma B et al. Paclitaxel and carboplatin in the treatment of small cell lung cancer patients resistant to cyclophosphamide, doxorubicin and etoposide: a non-cross resistant schedule. J Clin Oncol 1999; 17: 927-32.
  • Önen A, fianlı A. Senkron ve metakron akciğer kanserlerinde cerrahi tedavi. Toraks Dergisi 2004; 5(3): 201-7. Yazıflma Adresi: Dr. Onur TURAN
  • Dokuz Eylül Üniversitesi Tıp Fakültesi,
  • Göğüs Hastalıkları Anabilim Dalı, İZMİR
  • e-posta : onurtura@yahoo.com

RECURRENCE AND METACHRONOUS LUNG CANCER DEVELOPING AFTER CHEMOTHERAPY IN A PATIENT WITH SMALL CELL LUNG CARCINOMA

Year 2012, Volume: 26 Issue: 2, 129 - 135, 01.10.2012

Abstract

Small cell lung cancer (SCLC) is a kind of disease with a good response to chemotherapy, however it usually recurs in a short time and the most important reason of mortality is relapses. A sixty-two-year old male patient was diagnosed as SCLC, with an inoperable lesion in left lung. After 6 cycles of carboplatin and etoposide chemotherapy and radiotherapy, there was a total regression of the lesion. In following months, there was a new right pulmonary mass seen in thorax computed tomography (CT) which had the diagnosis of adenocarcinoma by transthoracic needle biopsy. It was accepted as a metachronous lung carcinoma and a new chemotherapy regimen including carboplatin and gemsitabine was administered, which created a total regression of the tumour for the second time. Nine months later, a mass invasing mediastinum was recognized in the same location with firstly diagnosed tumour, SCLC. This situation was named as recurrence of SCLC and the prior chemotherapy was administered again. We want to present this interesting case with the unexpected behaviour of tumour that contains both metachronous cancer and recurrence in a short time, and with the perfect response to the platin-based chemotherapy at every attack of the tumour.

References

  • Johnson, BE. Second lung cancers in
  • patients after treatment for an initial lung
  • cancer. J Natl Cancer Inst 1998; 90: 1335.
  • Li, X, Hemminki, K. Familial and second
  • lung cancers: a nation-wide epidemiologic
  • cancer. Lancet 2005; 366: 1385-96.
  • Antakli, T, Schaefer, RF, Rutherford, JE, et al. Second primary lung cancer. Ann Thorac Surg 1995; 59: 863-7.
  • Johnson BE, Cortazar P, Chute JP. Second lung cancers in patients successfully treated for lung cancer. Semin Oncol 1997; 24(4): 492-9.
  • Adebonojo, SA, Bowser AN, Moritz DM, Corcoran PC. The results of modern surgical therapy for multiple primary lung cancers Chest. 1999; 115(6): 1507-13.
  • Aziz, TM, Saad, RA, Glasser J, et al. The management of second primary lung cancers. A single centre experience in 15 years. Eur J Cardiothorac Surg 2002; 21: 527-33.
  • Matsui K, Sawa T, Suzuki H, Nakagawa K, Okamoto N, Tada T, Nagano T, Masuda N. Relapse of stage I small cell lung cancer ten or more years after the start of treatment. Jpn J Clin Oncol. 2006; 36(7): 457-61.
  • Saito Y, Hayakawa K, Mitsuhashi N, Nakajima N, Kato S, Nakazato Y, Niibe H. Late relapse of small cell lung cancer treated with radiation therapy alone--case report. Lung Cancer 1994; 10(5-6): 319-24.
  • Agra, Y, Pelayo, M, Sacristan, M, et al. Chemo- therapy versus best supportive care for extensive small cell lung cancer. Cochrane Database Syst Rev 2003 (4): CD001990.
  • Groen HJ, Fokkema E, Biesma B et al. Paclitaxel and carboplatin in the treatment of small cell lung cancer patients resistant to cyclophosphamide, doxorubicin and etoposide: a non-cross resistant schedule. J Clin Oncol 1999; 17: 927-32.
  • Önen A, fianlı A. Senkron ve metakron akciğer kanserlerinde cerrahi tedavi. Toraks Dergisi 2004; 5(3): 201-7. Yazıflma Adresi: Dr. Onur TURAN
  • Dokuz Eylül Üniversitesi Tıp Fakültesi,
  • Göğüs Hastalıkları Anabilim Dalı, İZMİR
  • e-posta : onurtura@yahoo.com
There are 18 citations in total.

Details

Other ID JA36FC99UD
Journal Section Case Report
Authors

Onur Turan This is me

Atila Akkoçlu This is me

Aydanur Kargı This is me

Emine Osma This is me

Publication Date October 1, 2012
Published in Issue Year 2012 Volume: 26 Issue: 2

Cite

APA Turan, O., Akkoçlu, A., Kargı, A., Osma, E. (2012). KÜÇÜK HÜCRELİ AKCİĞER KANSERLİ BİR OLGUDA TEDAVİ SONRASI REKÜRRENS VE METAKRON TÜMÖR GELİŞMESİ. İzmir Göğüs Hastanesi Dergisi, 26(2), 129-135.