Asunto(s)
Cuerpos Extraños/etiología , Arteria Pulmonar/patología , Embolia Pulmonar/etiología , Procedimientos Quirúrgicos Operativos/efectos adversos , Vena Cava Inferior , Anciano , Cuerpos Extraños/cirugía , Migración de Cuerpo Extraño , Humanos , Vértebras Lumbares/cirugía , Masculino , Arteria Pulmonar/cirugía , Embolia Pulmonar/cirugíaRESUMEN
This report describes a 62-year-old man who experienced elevated serum carbohydrate antigen 19-9 (CA19-9) levels (>500 U/mL) for 4 years, and was finally diagnosed with right intralobar pulmonary sequestration. Surgery confirmed the presence an aberrant artery arising from the descending thoracic aorta and entering the right lower lobe basal segment. Immunohistochemistry demonstrated markedly positive staining of CA19-9 in the ciliated cylindrical epithelia, alveoli, and mucus in the cysts. After pulmonary resection, CA19-9 levels decreased to within a normal range. Therefore, the cause of the elevated serum CA19-9 levels in this case was almost certainly due to intralobar pulmonary sequestration.
Asunto(s)
Biomarcadores/sangre , Secuestro Broncopulmonar/sangre , Antígeno CA-19-9/sangre , Secuestro Broncopulmonar/diagnóstico , Secuestro Broncopulmonar/cirugía , Antígeno CA-19-9/inmunología , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Neumonectomía , Tomografía Computarizada por Rayos XRESUMEN
Chemotherapy combining 5-fluorouracil (5-FU) with leucovorin is now used as a standard regimen for chemotherapy of inoperative, recurrent or distantly-metastasized colorectal carcinoma. We recently treated a patient with multiple metastases of sigmoid colon cancer by sigmoidectomy and oral drug therapy using a combination of Uzel (dl-leucovorin) and UFT (uracil and tegafur). Three courses of this therapy were administered, with each course consisting of treatment for 4 consecutive week (UFT 400 mg/day, Uzel 75 mg/day) and a one week interval between successive courses. The therapy resulted in marked reduction of tumor and this response was rated as PR (partial response). The lower lobe of the right lung, which showed the largest tumor (34.5 x 35.7 mm), was resected, and the upper lobe of the same lung, showing a small metastastic tumor (4.4 x 4.6 mm), was partially resected. Oral chemotherapy, which had begun before surgery, was continued after lobectomy and partial pneumonectomy. To date (January 15, 2005), the patient has received 5 courses of this therapy and has shown no signs of tumor exacerbation. Because this therapy has allowed satisfactory control of metastatic tumor for about one year since surgery without causing any adverse reaction or requiring re-hospitalization, it is fair to say that the therapy has successfully maintained the quality of life (QOL) of this patient.
