tailieunhanh - Báo cáo y học: "Multiple right-sided pulmonary nodules: metastatic cancer or resectable early stage tumor"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Multiple right-sided pulmonary nodules: metastatic cancer or resectable early stage tumor? | Cioffi et al. Journal of Cardiothoracic Surgery 2011 6 105 http content 6 1 105 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Multiple right-sided pulmonary nodules metastatic cancer or resectable early stage tumor 12 13 4 2 ugo Cioili Federico Rdveglid Vldtilde De Sirnune Vincenzo Valenti Michele M Ciulld dnd Alessdndro Bdisi Abstract The dim of this pdper Is to focus dttentlon on complex cdses of lung dlsedse thdt mdy benefit from being mdndged outside formdl guidelines. A 52 yedr-old mdn who hdd previously undergone d Idryngectomy for squdmous cell cdrcinomd presented with d cm nodule in the right upper pulmondry lobe. Three months ldter d new CT scdn found thdt the nodule hdd slightly incredsed in size dnd dlso detected two new smdller nodules in the middle lobe. A PET CT scdn showed metdbolic hyperactivity of dll nodules. Since needle dspirdtion of the upper one revedled mdligndnt cells the pdtient wds considered to be suffering from metdstdtic cdncer dnd stdrted on chemotherdpy. At follow-up both CT dnd PET scdns found d significdnt reduction in volume dnd dctivity of the lower nodules but no chdnge in the upper one. At didgnostic thordcoscopy histology demonstrdted thdt the upper nodule wds dn ddenocdrcinomd while the lower ones were infldmmdtory. An upper lobectomy dnd systematic noddl dissection were therefore performed. Histology estdblished d didgnosis of upper pulmondry ddenocdrcinomd dnd sdrcoidosis. Our report suggests thdt in complicdted oncologic cdses in which non-invdsive didgnostic tools yield incongruous results surgery should be considered without deldy. Keywords lung cdncer surgery metdstdsis PET CT scdn Introduction We report the case of a patient with three right pulmonary nodules and a previous advanced metastatic carcinoma of the pharynx. Follow-up and treatment were managed by a team of surgeons and oncologists according to the American College of Chest Physicians ACCP evidence-based .