[A case showing a complete response by weekly paclitaxel associated with severe empyema and mediastinal abscess caused by reduction of a recurrent lung metastatic tumor originating from adenocarcinoma of the esophagogastric junction after primary operation].
The patient was a 57-year-old man who presented with cancer of the esophagogastric junction. He underwent total gastrectomy, lower esophagectomy, distal pancreatectomy and splenectomy with para-aortic lymphnode dissection by the transthoracoabdominal approach. He was given a daily dose of 100 mg of S-1 as adjuvant chemotherapy. About one year after the operation, lung metastasis was recognized by enhanced CT examination. He began weekly paclitaxel as second-line chemotherapy. Paclitaxel was infused once a week. About two weeks after the first infusion therapy, he was admitted to our hospital with fever and dyspnea. A chest enhanced CT revealed remarkable empyema and mediastinal abscess. Chest drainage and mediastinal drainage were performed.After one month of drainage, the empyema and mediastinal abscess had improved. The metastastic tumor of the lung disappeared at the time of discharge. CR has been maintained for more than a year without chemotherapy.This case suggests that remarkable reduction of the tumor induced by chemotherapy may have caused the empyema and mediastinal abscess.
Dept. of Surgery, Kiryu Kosei General Hospital.
Akiharu
A
Kimura
Kiyoshi
K
Hiramatsu
Tadayuki
T
Sakuragawa
Takaaki
T
Ito
Hidehiko
H
Otsuji
Tomonori
T
Tsuchiya
Tomohiro
T
Hara
Takao
T
Maeda
Hiroshi
H
Tanaka
Yuichi
Y
Machiki
Jun
J
Hosoya
Tsuyoshi
T
Kojima
Kenji
K
Kato
D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016724:Empyema, Pleural / Q000150:complications* / Q000175:diagnosis; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy; D004943:Esophagogastric Junction / Q000473:pathology; D005743:Gastrectomy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D017239:Paclitaxel