内容紹介
A Case of Synchronous Double Cancer of the Lung and Stomach That Responded to Cisplatin and S-1 Combination Chemotherapy
Summary
A 55-year-old man experienced weight loss, as noted by a physician who was examining him for hypertension. Upper gastrointestinal endoscopy revealed a tumor lesion with an ulcer on the posterior wall of the greater curvature. A biopsy confirmed the presence of an adenocarcinoma(HER2 negative), and demonstrated enlarged para-aortic lymph nodes. Thus, stage Ⅳ type 3 ulcer infiltration-type gastric cancer was diagnosed. Computed tomography was included in the examination, and demonstrated nodular shadows in the right lower lobe and enlarged mediastinal nodes, as well as bilateral multiple granular shadows. Hence, bronchoscopy was performed, and another adenocarcinoma(EGFR mutation negative/EML4-ALK gene fusion negative)was diagnosed. Immunostaining showed that the pulmonary and gastric adenocarcinoma tissues were different, and synchronous double cancer was diagnosed. Four courses of CDDP/S-1 were administered, and both the lesions showed a partial response.
要旨
症例は55歳,男性。高血圧にて近医通院中に体重減少を認め,上部消化管内視鏡検査を施行したところ,大弯後壁に潰瘍を伴う腫瘍病変を認めた。生検にて腺癌(HER2陰性),全身検索にて傍大動脈リンパ節腫大を認め,stage Ⅳの3型潰瘍浸潤型胃癌と診断した。また,その際の胸部CTにて右下葉に結節影,縦隔リンパ節腫大,両側多発小粒状影を認めた。気管支鏡を施行し,腺癌(EGFR陰性,ALK陰性)と診断した。免疫染色にて胃病変と異なる組織であることを確認し,同時性重複癌と診断した。CDDP/S-1療法を4コース施行し,両病変ともにpartial responseを得た。
目次
Summary
A 55-year-old man experienced weight loss, as noted by a physician who was examining him for hypertension. Upper gastrointestinal endoscopy revealed a tumor lesion with an ulcer on the posterior wall of the greater curvature. A biopsy confirmed the presence of an adenocarcinoma(HER2 negative), and demonstrated enlarged para-aortic lymph nodes. Thus, stage Ⅳ type 3 ulcer infiltration-type gastric cancer was diagnosed. Computed tomography was included in the examination, and demonstrated nodular shadows in the right lower lobe and enlarged mediastinal nodes, as well as bilateral multiple granular shadows. Hence, bronchoscopy was performed, and another adenocarcinoma(EGFR mutation negative/EML4-ALK gene fusion negative)was diagnosed. Immunostaining showed that the pulmonary and gastric adenocarcinoma tissues were different, and synchronous double cancer was diagnosed. Four courses of CDDP/S-1 were administered, and both the lesions showed a partial response.
要旨
症例は55歳,男性。高血圧にて近医通院中に体重減少を認め,上部消化管内視鏡検査を施行したところ,大弯後壁に潰瘍を伴う腫瘍病変を認めた。生検にて腺癌(HER2陰性),全身検索にて傍大動脈リンパ節腫大を認め,stage Ⅳの3型潰瘍浸潤型胃癌と診断した。また,その際の胸部CTにて右下葉に結節影,縦隔リンパ節腫大,両側多発小粒状影を認めた。気管支鏡を施行し,腺癌(EGFR陰性,ALK陰性)と診断した。免疫染色にて胃病変と異なる組織であることを確認し,同時性重複癌と診断した。CDDP/S-1療法を4コース施行し,両病変ともにpartial responseを得た。