内容紹介
A Case with Double Primary Cancers in Both Lung and Nasal Cavity
Summary
Our patient, a 77-year-old male, underwent a medical examination for lower back pain. A careful investigation revealed two large tumors both in his lung and nose. The diagnosis was well-differentiated squamous cell carcinoma by biopsy in both sides. Radiation therapy(36 Gy)was performed on his nasal cavity, and nasal tumor volume was reduced considerably. Because the primary lesion could not be determined we used docetaxel chemotherapy which can be applied for both lung cancer and head and neck cancer. As a result, dissociation of the treatment's effect was seen, and we suspected the presence of overlapping cancer in both lung and nasal cavity. We could not use immunostaining to identify the primary lesion in squamous cell carcinoma as we did for adenocarcinoma. In this case we could infer the presence of overlapping cancer over the course of treatment with chemotherapy.
要旨
症例は77歳,男性。2011年9月に腰痛を認め当院受診。精査にて肺内と鼻腔に腫瘤を認めた。両部位での生検を施行し高分化型扁平上皮癌の診断となった。鼻腔の腫瘤に対しては放射線治療(36 Gy)を施行し著明な縮小効果が得られた。原発巣の同定が困難であったため肺癌と頭頸部癌の両者に有効とされるdocetaxelによる化学療法を行った。その結果,肺内の結節において治療効果の解離がみられ重複癌が示唆された。腺癌領域における原発巣の同定に有用な免疫染色マーカーは扁平上皮癌においてはないのが現状である。本症例は化学療法における治療経過から重複癌であることが類推された症例である。
目次
Summary
Our patient, a 77-year-old male, underwent a medical examination for lower back pain. A careful investigation revealed two large tumors both in his lung and nose. The diagnosis was well-differentiated squamous cell carcinoma by biopsy in both sides. Radiation therapy(36 Gy)was performed on his nasal cavity, and nasal tumor volume was reduced considerably. Because the primary lesion could not be determined we used docetaxel chemotherapy which can be applied for both lung cancer and head and neck cancer. As a result, dissociation of the treatment's effect was seen, and we suspected the presence of overlapping cancer in both lung and nasal cavity. We could not use immunostaining to identify the primary lesion in squamous cell carcinoma as we did for adenocarcinoma. In this case we could infer the presence of overlapping cancer over the course of treatment with chemotherapy.
要旨
症例は77歳,男性。2011年9月に腰痛を認め当院受診。精査にて肺内と鼻腔に腫瘤を認めた。両部位での生検を施行し高分化型扁平上皮癌の診断となった。鼻腔の腫瘤に対しては放射線治療(36 Gy)を施行し著明な縮小効果が得られた。原発巣の同定が困難であったため肺癌と頭頸部癌の両者に有効とされるdocetaxelによる化学療法を行った。その結果,肺内の結節において治療効果の解離がみられ重複癌が示唆された。腺癌領域における原発巣の同定に有用な免疫染色マーカーは扁平上皮癌においてはないのが現状である。本症例は化学療法における治療経過から重複癌であることが類推された症例である。