title: [A Patient with CA19-9-Producing Pulmonary Adenocarcinoma Who Responded to Multidisciplinary Therapy and Achieved Complete Response].
abstract: The patient, a man in his 60s, visited his physician with hemosputum. The shadow of a large mass, measuring approximately 6 cm in diameter, was observed in the left upper lung field, and the patient was referred to our hospital. After thorough examination, the mass was diagnosed as a pulmonary adenocarcinoma. In addition, serum CA19-9 levels were elevated(608.9 U/mL). Based on the PET-CT scan, the cancer was diagnosed as cT2bN1M0, stage II B disease and surgery was performed. The thorax was opened via a posterolateral incision; left upper lobectomy and lymph node dissection(ND2a-2)were performed. The lesion, measuring 56×59×44 mm, was excised from S1+2. The histopathological diagnosis was poorly-differentiated adenocarcinoma(mucin-producing adenocarcinoma). On immunostaining, the lesion was CA19-9-positive and was confirmed as pT2bN1M0, stage II B disease. The serum CA19-9 level was still elevated after surgery(83.2 U/mL). Therefore, 6 courses of adjuvant chemotherapy(carboplatin plus weekly paclitaxel)were administered. Grade 2 adverse events included hair loss and neutropenia. Thus, the drug withdrawal period was extended. After completion of 2 courses of the therapy, the serum CA19-9 level normalized. Two years after surgery, there has been no sign of recurrence.
authors.affiliation: Dept. of Surgery, Anan Medical Association Center Hospital.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Katayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Hideko
authors.initials: H
authors.lastname: Endo
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000032:analysis / Q000096:biosynthesis*; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008175:Lung Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D009503:Neutropenia; D017239:Paclitaxel / Q000008:administration & dosage
chemical_list: D018395:CA-19-9 Antigen; D016190:Carboplatin; D017239:Paclitaxel