内容紹介
A Case of Unknown Primary Carcinoma with Dermatomyositis
Summary
A 50-year-old woman was diagnosed with dermatomyositis at the department of neurology in our hospital; she then received steroid pulse therapy. A positron emission computed tomography(PET-CT)revealed swollen lymph nodes near the aorta and in the left inguinal region. She presented at our institution for examination to determine the cause of her lymphadenopathy, but the primary site of the carcinoma was unknown. A histopathological examination of the lymph node specimen obtained using endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA)revealed a moderately to poorly differentiated adenocarcinoma. The patient underwent lymphadenectomy. After the surgery, a new lymph node metastasis appeared in the lower abdomen. We initiated a combination treatment with chemotherapy and radiotherapy. The patient died because of disease progression 31 months after her first visit.
要旨
症例は50歳,女性。皮膚筋炎の診断で当院神経内科にてステロイドパルス療法を施行された。PET-CTで傍大動脈および左鼠径部に異常集積を認めたため当科を紹介され,傍大動脈リンパ節に対しEUS-FNAを施行し,病理組織学的に中～低分化型腺癌の診断となった。原発不明癌の診断で外科的リンパ節摘出術を施行したが,術後に新規転移再発病変を認め,全身化学療法および放射線治療を施行し,初診から31か月後に原病死した。
目次
Summary
A 50-year-old woman was diagnosed with dermatomyositis at the department of neurology in our hospital; she then received steroid pulse therapy. A positron emission computed tomography(PET-CT)revealed swollen lymph nodes near the aorta and in the left inguinal region. She presented at our institution for examination to determine the cause of her lymphadenopathy, but the primary site of the carcinoma was unknown. A histopathological examination of the lymph node specimen obtained using endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA)revealed a moderately to poorly differentiated adenocarcinoma. The patient underwent lymphadenectomy. After the surgery, a new lymph node metastasis appeared in the lower abdomen. We initiated a combination treatment with chemotherapy and radiotherapy. The patient died because of disease progression 31 months after her first visit.
要旨
症例は50歳,女性。皮膚筋炎の診断で当院神経内科にてステロイドパルス療法を施行された。PET-CTで傍大動脈および左鼠径部に異常集積を認めたため当科を紹介され,傍大動脈リンパ節に対しEUS-FNAを施行し,病理組織学的に中～低分化型腺癌の診断となった。原発不明癌の診断で外科的リンパ節摘出術を施行したが,術後に新規転移再発病変を認め,全身化学療法および放射線治療を施行し,初診から31か月後に原病死した。