Kanseri y'ibihaha ifata uturemangingo duto two mu bihaha-01

Muri Kamena 2022, umurwayi w'umugabo w'imyaka 65 yakorewe isuzuma ry'umubiri risanzwe, maze scan ya CT igaragaza ko hari agahu munsi y'umusemburo mu gice cyo hejuru cy'iburyo cy'ibihaha. Muri Mutarama 2023, umurwayi yatangiye kugira ibimenyetso nko gushwanyagurika, gukorora no guhumeka nabi. Muri Gicurasi 2023, inkorora ye no guhumeka nabi byari byararushijeho kwiyongera. Isuzuma ryagaragaje ko imikorere y'imikorere y'umubiri yiyongereye cyane mu gice cyo hejuru cy'iburyo cy'ibihaha, bigaragaza cyane kanseri y'ibihaha. Byongeye kandi, imikorere y'imikorere y'umubiri yiyongereye mu bice byinshi bya lymph, harimo agace k'iburyo ka supraclavicular, mediastinum, trachea, agace ka para-aortic, na inferior vena cava. Amashusho yanagaragaje ko hari uduce twinshi twinshi twinshi mu gice cyo hejuru cy'iburyo cy'umusemburo w'iburyo hamwe n'imikorere y'imikorere y'umubiri yiyongereye. Ibisubizo by'isuzuma byagaragaje ko hari agahu gakomeye mu gice cyo hejuru cy'iburyo cy'umusemburo w'iburyo hamwe n'impinduka mu mikorere y'umubiri, kandi isuzuma rya nyuma rya kanseri y'uturemangingo duto tw'ibihaha ryemejwe binyuze mu isuzuma ry'indwara, amashusho, na immunohistochemistry. Hanyuma umurwayi yahawe ubuvuzi bufatika.

Nyuma y'amezi atanu, ingano y'ikibyimba yari yagabanutse cyane, kandi ibisebe byinshi bya metastasis byari byarazimye. Gahunda yo kuvura yarimo gutangira imiti ya atezolizumab immunotherapy ivanze n'ubuvuzi bwa anlotinib. Atezolizumab yahawe ku gipimo cya 1200 mg ku munsi wa mbere, hagakurikiraho guhagarika kuvura. Anlotinib yahawe mu kanwa ku gipimo cya 10 mg buri munsi mu byumweru bibiri bikurikiranye, hagakurikiraho iminsi irindwi yo kuruhuka, bimara iminsi 21 yo kuvura. Nyuma y'ibikorwa 15 byo kuvura hakoreshejwe imirasire, amashusho ya CT yagaragaje igabanuka rikomeye ry'igisebe mu bihaha by'iburyo, kandi mediastinum y'iburyo na lymph nodes nazo zaragabanutse cyane. Isuzuma rya CT ryakurikiyeho ku ya 10 Nzeri 2023, ryagaragaje impinduka nziza: kugabanuka k'umuvuduko w'amaraso mu buryo bw'iburyo, kugabanuka k'ububyimba bw'amaraso mu buryo bw'iburyo, no kugabanuka k'udukoko tw'amaraso mu buryo bw'iburyo no mu buryo bw'iburyo, nta kwiyongera k'udukoko tw'amaraso mu nda no mu gifu.

Ugereranije n’isuzuma ryakozwe ku ya 7 Gicurasi 2023, isuzuma ryo ku ya 10 Ukwakira 2023 ryagaragaje igabanuka rikomeye ry’ikibyimba. By’umwihariko, gucikagurika kwagaragaye mu gice cy’inyuma cy’iburyo no mu bice byinshi bya lymph hafi ya trachea, imiyoboro y’amaraso, agace ka para-aortic, no mu gice cya vena cava kiri munsi yacyo. Ubunini bw’ibibyimba bwagaragaye mbere mu gice cya peritoneum cyo mu gace, ku rukuta rw’imbere rw’igituza, no ku gice cya 11-12 cy’intercostal bwari bwaragabanutse cyane. Byongeye kandi, igicucu cy’ibibyimba biri hasi gato mu mitsi y’urutugu rw’iburyo nacyo cyari cyaragabanutse cyane. Ibi byavuye mu bushakashatsi bigaragaza ko uburyo bwo kuvura umubiri bwari bufite akamaro, aho ibibyimba byinshi byanduye bishira naho ibindi bibyimba bigabanuka cyane. Isuzuma ry’amashusho ryerekana ko uburyo bwo kuvura bwagenze neza, kandi ikibyimba ubu kiri mu cyiciro cyo koroherwa.