通过内镜治疗和奥希替尼全身治疗控制出血的十二指肠肺癌乳头状转移:病例报告。

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY Case Reports in Gastroenterology Pub Date : 2024-03-12 eCollection Date: 2024-01-01 DOI:10.1159/000537778
Taiyo Hirata, Shinya Kawaguchi, Taisuke Akamatsu, Atsuko Inagawa, Tomoki Hikichi, Kohei Ohkawa, Kazuhisa Asahara, Tatsunori Satoh, Shinya Endo, Makoto Suzuki, Kazuya Ohno
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引用次数: 0

摘要

导言:实体器官恶性肿瘤很少转移到十二指肠乳头。我们描述了一例原发性肺癌伴十二指肠乳头转移的病例,患者曾出现血便。据我们所知,这是第二例肺癌十二指肠乳头转移病例:一名 65 岁的妇女主诉厌食、体重减轻和黑便。通过影像学检查,临床诊断为肺癌 IVB 期,并开始使用抗凝药物治疗肺动脉血栓。然而,由于十二指肠乳头状肿瘤出血,内镜止血面临挑战。幸运的是,患者的血浆表皮生长因子受体(EGFR)基因突变呈阳性,于是使用了表皮生长因子受体酪氨酸激酶抑制剂奥希替尼,成功实现了止血。随后,在内镜超声引导下对肿大的纵隔淋巴结进行了经支气管针吸术,并对十二指肠乳头状肿瘤进行了活检,证实了原发肺腺癌的十二指肠乳头状转移:尽管十二指肠乳头转移瘤极为罕见,但通过将肺癌十二指肠乳头转移瘤作为鉴别诊断并给予奥希替尼全身治疗,该病例取得了良好的临床疗效。
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Duodenal Papillary Metastasis of Lung Cancer with Bleeding Controlled by Endoscopic Treatment and Systemic Osimertinib Therapy: Case Report.

Introduction: Solid organ malignancies rarely metastasize to the duodenal papilla. We describe a case of primary lung cancer with duodenal papillary metastasis in a patient who presented with melena. To the best of our knowledge, this is only the second report of duodenal papillary metastasis from lung cancer.

Case presentation: A 65-year-old woman presented with complaints of anorexia, weight loss, and black stool. Imaging studies led to a clinical diagnosis of stage IVB lung cancer, and anticoagulants were initiated to treat pulmonary artery thrombosis. However, endoscopic hemostasis was challenging because of bleeding from a duodenal papillary tumor. Fortunately, the patient was positive for the plasma epidermal growth factor receptor (EGFR) gene mutation, and osimertinib, an EGFR tyrosine kinase inhibitor, was administered, successfully achieving hemostasis. Subsequently, endoscopic ultrasonography-guided transbronchial needle aspiration of an enlarged mediastinal lymph node and duodenal papillary tumor biopsy confirmed duodenal papillary metastasis of the primary lung adenocarcinoma.

Conclusion: Although duodenal papillary metastasis is extremely rare, a good clinical outcome was achieved in this case by considering duodenal papillary metastasis from lung cancer as the differential diagnosis and administering systemic osimertinib therapy.

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来源期刊
Case Reports in Gastroenterology
Case Reports in Gastroenterology Medicine-Gastroenterology
CiteScore
1.10
自引率
0.00%
发文量
99
审稿时长
7 weeks
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