Akciğerin dev hücreli tümörü: cerrahi tedavi yönetimi

Year 2019, Volume: 11 Issue: 2, 125 - 130, 01.06.2019

Funda İncekara , Ebru Sayılır Güven Şevki Mustafa Demiröz , Merve Şengül İnan Koray Aydoğdu , Funda Demirağ Selim Şakir Erkmen Gülhan Sadi Kaya , Göktürk Fındık

https://doi.org/10.21601/ortadogutipdergisi.440816

Abstract

Amaç: Pulmoner dev hücreli karsinom (PDHK) küçük
hücreli dışı akciğer kanserinin bir histolojik tipidir ve akciğer sarkomatoid karsinomunun
beş subtipinden biri olarak sınıflandırılır. Pür PDHK çok nadirdir.

 Gereç ve Yöntem: Kliniğimizde PDHK nedeni ile tedavi gören 7 hastayla
ilgili tecrübelerimizi sunduk (6 erkek ve 1 kadın, yaş aralığı 46-63 yıl). En sık
görülen semptomlar öksürük ve hemoptizi idi. Üst lobektomi (n=7) ve ek olarak mediastinal
lenfadenektomi bütün hastalara uygulandı.

Bulgular: Kesin histolojik inceleme ile tüm hastalarda PDHK tanısı doğrulandı.
Herhangi bir perioperatif mortalite görülmemesine rağmen bir olguda ameliyat sonrası
komplikasyon gelişti; erken perioperatif dönemde hemoraji ve operasyondan iki ay
sonra bronşiyal fistül gelişti. Hastaların ortalama sağkalımı 28,8 ay (38 gün-116
ay) olarak bulundu.

Sonuç: PDHK için asıl tedavi komplet cerrahi rezeksiyondur. Komplet cerrahi
rezeksiyonun erken evre PDHK için yararlı bir tedavi tercihi olduğu ve sağkalıma
katkı sağladığı bulunmuştur.

Keywords

Kemoterapi, dev hücreli karsinom, radyoterapi, cerrahi, Dünya Sağlık Örgütü

Giant Cell Carcinoma of the Lung: Management of Surgical Treatment

Abstract

Objectives: Pulmonary giant cell carcinoma (PGCC) is a
histological type of nonsmall cell lung cancer and classified as one of the five
subtypes of sarcomatoid carcinoma of the lung. Pure PGCC is very rare.

Material and Method: We represent our experience in the management
of 7 patients (6 males and 1 female, with a range of 44-63 yr) with PGCC. The most
representing symptoms were cough and hemoptysis. Upper lobectomy (n=7) and additionally
mediastinal lymphadenectomy were performed in all patients.

Results: Definitive histological examination confirmed
the diagnosis of PGCC in all cases. Even though there was no perioperative mortality,
postoperative complications developed in a case were hemorrhage in the early perioperative
period and bronchus fistula after two months from the operation. The mean survival
of the patients was estimated as 28.8 months (38 days - 116 months).

Conclusion: The main treatment for PGCC is the complete
surgical resection. Complete surgical resection was found to be usefull as a treatment
of choice of PGCC in the early stage and contributed to survival.

Keywords

Chemotherapy, giant cell carcinoma, radiotherapy, surgery, World Health Organization

References

• Nash AD, Stout AP. Giant cell carcinoma of the lung: Report of 5 cases. Cancer 1958; 11: 369-76.
• Travis WD. Pathology of lung cancer. Clin Chest Med 2002; 23: 65-81.
• Fishback NF, Travis WD, Moran CA, Guinee DG Jr, McCarthy WF, Koss MN. Pleomorphic (spindle/giant cell) carcinoma of the lung. A clinicopathologic correlation of 78cases. Cancer 1994; 73: 2936-45.
• Travis WD. Sarcomatoid neoplasms of the lung and pleura. Archives of Pathology and Laboratory Medicine 2010; 134: 1645-58.
• Kerr KM, Pelosi G, Austin JHM, Van Schil P. Pleomorphic, spindle cell, and giant cell carcinoma. WHO classification of tumours of the lung, pleura, thymus and heart/Travis, William D.[edit.]; et al. 2015. 88-90.
• Yendamuri S, Caty L, Pine M, et al. Outcomes of sarcomatoid carcinoma of the lung: a surveillance, epidemiology, and end results database analysis. Surgery 2012; 152: 397-402.
• Flanagan P, Roeckel IE. Giant Cell Carcinoma of the Lung: Anatomic and Clinical Correlation. American Journal of Medicine1964; 36: 214-21.
• Hellstrom HR, Fisher ER. Giant cell carcinoma of lung. Cancer 1963; 16: 1080-8.
• Ginsberg S, Buzaid A, Stern H, Carter D. Giant cell carcinoma ofthe lung. Cancer 1992; 70: 606-10.
• Depuel RH, Ballard BR. Pulmonary giant cell carcinoma: the relation to smoking. Br.J. Cancer 1989; 60: 599-600.
• Ito K, Oizumi S, Fukumoto S, Harada M, IshidaT, Fujita Y et al. Lung Cancer Clinical Study Group. Clinical characteristics of pleomorphic carcinoma of the lung. Lung Cancer, 2010; 68: 204- 10.
• Travis, William D. “Reporting lung cancer pathology specimens. Impact of the anticipated 7th Edition TNM classification based on recommendations of the IASLC Staging Committee.” Histopathology 2009; 54: 3-11.
• Zhao Z, Liu H, Zhao H, Song N, Liu Y. Lung carcinoma with spindle and/or giant cell: a clinicopathological analysis of 17cases. Chinese-German J Clin Oncol 2009; 8: 1-6.
• Kallenberg, Flemming, and John Jaqué. Giant-cell carcinoma of the lung. Clinical and pathological assessment. Comparison with other large-cell anaplastic bronchogenic carcinomas. Scand J Thoracic Cardiovascular Surg 1979; 13: 343-6.
• Byers, Tim E., John E. Vena, and Thomas F. Rzepka. Predilection of Lung Cancer for the Upper Lobes: An Epidemiologic Inquiry 2. Journal of the National Cancer Institute 1984; 72: 1271-5.