Ọrịa kansa akpa ume nke obere mkpụrụ ndụ metastatic-01

Na June 2022, otu nwoke dị afọ 65 mere nyocha ahụ nkịtị, nyocha CT gosiri ihe mgbaàmà dị n'okpuru pleura n'ime akụkụ aka nri nke akpa ume. Na Jenụwarị 2023, onye ọrịa ahụ malitere inwe ihe mgbaàmà dịka mkpọtụ olu, ụkwara, na mkpụmkpụ ume. Ka ọ na-erule Mee 2023, ụkwara na mkpụmkpụ ume ya akala njọ. Nyocha ahụ gosiri mmụba nke ukwuu na ọrụ metabolic na akụkụ aka nri nke akpa ume, nke na-egosi nke ukwuu na ọ nwere ọrịa kansa akpa ume. Na mgbakwunye, a hụrụ mmụba nke ọrụ metabolic na ọtụtụ akụkụ lymph, gụnyere mpaghara aka nri nke supraclavicular, mediastinum, trachea, mpaghara para-aortic, na obere vena cava. Foto ndị ahụ kpughekwara ọtụtụ ọkpụrụkpụ nodular na pleura aka nri yana mmụba nke ọrụ metabolic. Nsonaazụ nyocha gosiri metastasis pleural aka nri yana pleural effusion, a kwadokwara nchọpụta ikpeazụ nke kansa akpa ume obere cell metastatic site na nyocha ọrịa, onyonyo, na immunohistochemistry. Onye ọrịa ahụ mechara nweta ọgwụgwọ nke ọma.

Ọnwa ise ka nke ahụ gasịrị, oke etuto ahụ belatara nke ukwuu, ọtụtụ ọnya metastatic apụọla. Usoro ọgwụgwọ ahụ gụnyere ọgwụgwọ immunotherapy atezolizumab mbụ yana ọgwụgwọ anlotinib ezubere iche. E nyere Atezolizumab na dose nke 1200 mg n'ụbọchị mbụ, wee kwụsị n'ọgwụgwọ. E nyere Anlotinib ọnụ na dose nke 10 mg kwa ụbọchị maka izu abụọ n'usoro, wee kwụsịtụ ụbọchị asaa, wee mepụta usoro ọgwụgwọ ụbọchị 21. Mgbe oge redio 15 gasịrị, onyonyo CT gosiri mbelata dị ukwuu na mmerụ ahụ na akpa ume aka nri, mediastinum na lymph aka nri ebelatakwala nke ukwuu. Nyocha CT ọzọ na Septemba 10, 2023, gosiri mgbanwe dị mma: mbelata na pleural effusion aka nri, mbelata pleural thickening aka nri, na obere mediastinal na supraclavicular lymph nodes aka nri, na-enweghị mmụba nke afọ na retroperitoneal lymph nodes.

Ma e jiri ya tụnyere nyocha ahụ na Mee 7, 2023, nyocha ahụ na Ọktoba 10, 2023 gosiri mbelata dị ukwuu na etuto ahụ. N'ụzọ pụrụ iche, a hụrụ mbelata na nodule dị n'elu lobe aka nri na n'ọtụtụ lymph nodes dị nso na trachea, arịa ọbara, mpaghara para-aortic, na inferior vena cava. Mkpụkọ nodular a hụrụ na mbụ na peritoneum mpaghara, mgbidi obi aka nri, na oghere intercostal nke 11-12 ebelatala nke ukwuu. Na mgbakwunye, onyinyo nodular dị obere obere na akwara ubu aka nri ebelatakwala nke ukwuu. Nsonaazụ ndị a na-egosi na usoro ọgwụgwọ sistemụ dị irè, ebe ọtụtụ ọnya metastatic na-apụ n'anya na ọnya ndị fọdụrụ na-ebelata nke ukwuu. Nyocha onyonyo na-egosi na usoro ọgwụgwọ ahụ gara nke ọma, etuto ahụ dịkwa ugbu a n'ọkwa mwepụ akụkụ.