[A case of mediastinal metastasis of renal small cell carcinoma, performing CHOP therapy for an acute respiratory failure by the air way obstruction under the mechanical ventilation].
A case of mediastinal metastasis of renal small cell carcinoma was reported. A 45-year-old female was admitted to our hospital complaining of worsening dyspnea. The chest radiograph and CT showed stenosis of the bronchi bilaterally due to the mediastinal mass. Prior to pathological diagnosis, CHOP therapy with cyclophosphamide, adriamycin, vincristine and prednisolone was performed under mechanical ventilation for the purpose of resuscitation. The therapy was effective; and the was weaned from the mechanical ventilator, resulting in complete remission. Transbronchial samples from the left main bronchus confirmed that the mediastinal mass was identical pathologically to the renal small cell carcinoma (RSCC) resected 5 years before. As a result, the mediastinal mass was diagnosed as a metastatic focus of RSCC. RSCC is known to have one of the most unfavorable prognoses among malignancies. Despite efforts with chemotherapy, almost all cases that appear in the literature died within 1 year after diagnosis. No standard treatment modality has yet been established. Thus, the present case is rare because an RSCC relapse after a long free period went into remission as a result of CHOP therapy. It is suggested that CHOP therapy may well be an effective tool against RSCC, and could be a valuable choice for a treatment regimen.
Fujisawa
Toshio
T
Department of Pulmonary Medicine, St. Luke's International Hospital, Tokyo, Japan.
Aoshima
Masahiro
M
Uchiyama
Noboru
N
Satoh
Tadashi
T
Ohmagari
Norio
N
Chonabayashi
Naohiko
N
Saiki
Shigeki
S
Suzuki
Kohyuh
K
D000208:Acute Disease; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008479:Mediastinal Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone