Ka maʻi ʻaʻai māmā liʻiliʻi metastatic-01

I Iune 2022, ua hana ʻia kahi hoʻokolohua kino maʻamau no kekahi kāne maʻi 65 makahiki, a ua hōʻike ʻia kahi CT scan i kahi nodule ma lalo o ka pleura ma ka ʻākau o luna o ka māmā. I Ianuali 2023, ua hoʻomaka ka mea maʻi e ʻike i nā hōʻailona e like me ka leo haʻalulu, ka ʻūlū, a me ka hanu pōkole. I Mei 2023, ua ʻoi aku ka ʻino o kona ʻūlū a me ka hanu pōkole. Ua hōʻike nā scan i ka hoʻonui nui ʻia o ka hana metabolic ma ka ʻākau o luna o ka lobe lung nodule, he hōʻike nui ia no ka maʻi kanesa māmā. Eia kekahi, ua ʻike ʻia ka hoʻonui ʻia o ka hana metabolic ma nā lymph node he nui, me ka ʻākau supraclavicular region, mediastinum, trachea, para-aortic area, a me ka inferior vena cava. Ua hōʻike pū nā kiʻi i nā mānoanoa nodular he nui ma ka pleura ʻākau me ka hoʻonui ʻia o ka hana metabolic. Ua hōʻike nā hopena o ka hoʻokolokolo ʻana i ka metastasis pleural ʻākau me ka pleural effusion, a ua hōʻoia ʻia ka hopena hope loa o ka metastatic small cell lung cancer ma o ka hoʻokolokolo pathological, imaging, a me immunohistochemistry. A laila ua loaʻa i ka mea maʻi ka lāʻau lapaʻau.

ʻElima mahina ma hope mai, ua emi nui ka nui o ka puʻupuʻu, a ua nalowale ka hapa nui o nā ʻeha metastatic. Ua komo pū ka papa hana lapaʻau me ka immunotherapy atezolizumab mua i hui pū ʻia me ka lāʻau lapaʻau i kuhikuhi ʻia e anlotinib. Ua lawelawe ʻia ʻo Atezolizumab ma kahi mahele o 1200 mg i ka lā mua, a ukali ʻia e kahi hoʻomaha i ka mālama ʻana. Ua hāʻawi waha ʻia ʻo Anlotinib ma kahi mahele o 10 mg i kēlā me kēia lā no ʻelua pule i ka lālani, a ukali ʻia e kahi manawa hoʻomaha ʻehiku lā, e hana ana i kahi pōʻaiapuni lapaʻau 21 lā. Ma hope o 15 mau kau o ka radiotherapy, ua hōʻike nā kiʻi CT i kahi emi nui o ka ʻeha ma ka māmā ʻākau, a ua emi nui hoʻi ka mediastinum ʻākau a me nā lymph nodes. Ua hōʻike kahi CT scan ma hope o Kepakemapa 10, 2023, i nā loli maikaʻi: ka emi ʻana o ka effusion pleural ʻākau, ka emi ʻana o ka mānoanoa o ka pleural ʻākau, a me nā lymph nodes mediastinal a me ka ʻākau supraclavicular liʻiliʻi, me ka ʻole o ka hoʻonui ʻia ʻana o nā lymph nodes abdominal a me retroperitoneal.

I ka hoʻohālikelike ʻia me ke scan ma Mei 7, 2023, ua hōʻike ke scan ma ʻOkakopa 10, 2023 i kahi emi nui o ka puʻupuʻu. ʻO ke kikoʻī, ua ʻike ʻia ka emi ʻana ma ka nodule ma ka lobe ʻākau o luna a ma kekahi mau lymph node kokoke i ka trachea, nā kīʻaha koko, ka ʻāpana para-aortic, a me ka vena cava haʻahaʻa. Ua emi nui ka mānoanoa o ka nodular i ʻike mua ʻia ma ka peritoneum kūloko, ka paia umauma mua ʻākau, a me ka hakahaka intercostal 11-12. Eia kekahi, ua emi nui ka aka nodular haʻahaʻa iki ma ka ʻiʻo poʻohiwi ʻākau. Hōʻike kēia mau hopena ua kūpono ka regimen lapaʻau systemic, me ka nalowale ʻana o ka hapa nui o nā lesion metastatic a me ka emi nui ʻana o nā lesion i koe. Hōʻike nā loiloi kiʻi ua holomua ka regimen lapaʻau, a aia ka puʻupuʻu i kahi pae hoʻomaha hapa.