内容紹介
Transcatheter Arterial Chemoembolization with Superabsorbent Polymer Microspheres for a Large Lung Cystic Adenocarcinoma in the Left Pulmonary Cavity
Summary
A 57-year-old woman presented with lung adenocarcinoma and carcinomatous pleurisy in January 2013. The primary lesion had been treated with 60-Gy radiation therapy. She, however, showed a recurrence of the tumor in her pulmonary cavity. She received systemic chemotherapy for 1 year but did not show any improvement. She visited our clinic in March 2014. Her performance level was 3. Her hemoglobin level was 8.5 g/dL. The CT scan showed that the size of the cystic tumor was 200×144×143 mm. The tumor severely compressed her heart. We performed TACE using a spherical embolic agent. The microcatheter was guided through the left bronchial artery; left intercostal artery 9, 10, and 11; and the left inferior phrenic artery. The anticancer drugs selected were CDDP and 5-FU. The embolic material used was SAP-MS. After 3 therapy sessions, the CT scan showed shrinkage of the target lesion to 100×93×54 mm. Her hemoglobin level increased to 13.8 g/dL; furthermore, the severity of dyspnea decreased, and she showed a performance status of 0. TACE with SAP-MS was successfully performed for the large cystic tumor in the pulmonary cavity that metastasized from the lung cancer and was refractory to standard treatments. After the treatment, the tumor size decreased and the patient's symptoms alleviated.
要旨
57歳,女性。左胸腔内巨大腫瘤。2013年1月,左肺尖部原発肺腺癌。原発巣は放射線治療60 Gyで局所制御を得た。その後,全身化学療法を施行するも左胸腔内腫瘤増大,血性胸水,血痰は持続した。2014年3月,当院紹介受診。PS 3,在宅酸素療法が導入され,起座呼吸の状態であった。血色素は8.5 g/dLと低値を示した。造影CTでは左胸腔内嚢胞状腫瘤は200×144×143 mm,心臓は腫瘤により背側から圧排されていたため,腫瘤の縮小を目的に2014年4～6月にかけて3回の動注塞栓術を施行した。選択した血管は左気管支動脈,左第9,10,11肋間動脈,左下横隔動脈。動注薬剤はCDDP,5-FU,塞栓物質は球状塞栓物質を使用した。9月の経過観察で主病変は100×93×54 mmに縮小。血色素は13.8 g/dL,呼吸苦は改善しPS 0となった。全身化学療法不応例に対し動注塞栓術が奏効した症例を報告する。
目次
Summary
A 57-year-old woman presented with lung adenocarcinoma and carcinomatous pleurisy in January 2013. The primary lesion had been treated with 60-Gy radiation therapy. She, however, showed a recurrence of the tumor in her pulmonary cavity. She received systemic chemotherapy for 1 year but did not show any improvement. She visited our clinic in March 2014. Her performance level was 3. Her hemoglobin level was 8.5 g/dL. The CT scan showed that the size of the cystic tumor was 200×144×143 mm. The tumor severely compressed her heart. We performed TACE using a spherical embolic agent. The microcatheter was guided through the left bronchial artery; left intercostal artery 9, 10, and 11; and the left inferior phrenic artery. The anticancer drugs selected were CDDP and 5-FU. The embolic material used was SAP-MS. After 3 therapy sessions, the CT scan showed shrinkage of the target lesion to 100×93×54 mm. Her hemoglobin level increased to 13.8 g/dL; furthermore, the severity of dyspnea decreased, and she showed a performance status of 0. TACE with SAP-MS was successfully performed for the large cystic tumor in the pulmonary cavity that metastasized from the lung cancer and was refractory to standard treatments. After the treatment, the tumor size decreased and the patient's symptoms alleviated.
要旨
57歳,女性。左胸腔内巨大腫瘤。2013年1月,左肺尖部原発肺腺癌。原発巣は放射線治療60 Gyで局所制御を得た。その後,全身化学療法を施行するも左胸腔内腫瘤増大,血性胸水,血痰は持続した。2014年3月,当院紹介受診。PS 3,在宅酸素療法が導入され,起座呼吸の状態であった。血色素は8.5 g/dLと低値を示した。造影CTでは左胸腔内嚢胞状腫瘤は200×144×143 mm,心臓は腫瘤により背側から圧排されていたため,腫瘤の縮小を目的に2014年4～6月にかけて3回の動注塞栓術を施行した。選択した血管は左気管支動脈,左第9,10,11肋間動脈,左下横隔動脈。動注薬剤はCDDP,5-FU,塞栓物質は球状塞栓物質を使用した。9月の経過観察で主病変は100×93×54 mmに縮小。血色素は13.8 g/dL,呼吸苦は改善しPS 0となった。全身化学療法不応例に対し動注塞栓術が奏効した症例を報告する。