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開催概要
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第56回・2018年・横浜
 

治療に難渋した原発不明小細胞型神経内分泌癌の一例

演題番号 : P110-4

[筆頭演者]
演者)星野 舞:1 
[共同演者]
船越 信介:1、青木 優:1、酒井 元:1、廣瀬 茂道:2

1:東京都済生会中央病院・腫瘍内科、2:東京都済生会中央病院・病理診断科

 

Introduction: Extrapulmonary small cell carcinomas (EPSCCs) can occur in multiple sites of origin, most commonly the gastrointestinal tract, the genitourinary tract,and the head and neck region. On the other hand, small cell carcinoma of unknown primary (SCUP) has always been included in EPSCCs. The true incidence of SCUP is unknown but has been reported to be between 7-30% of EPSCCs. Standard therapy for SCUP remains unestablished due to its rarity.
Case: A 40-year-old female was admitted to our hospital due to genital bleeding, and sacrum pain. CT scan showed diffuse enlargement of the uterine cervix and multiple metastatic tumors in bones, liver, lung, peritoneum, and lymph nodes. No primary lesion was detected by upper gastrointestinal endoscopy and total colonoscopy. After performing liver tumor biopsy, EPSCCs was diagnosed due to TTF-1 negative. Although the cytological findindgs from uterine revealed resembled the cancer cells in liver tumor, we diagnosed as SCUP. Palliative irradiation was performed to the bone pain of the right sacrum. After 3 courses of first line cisplatin plus irinotecan chemotherapy, CT scan showed progression of disease. The amount of uterine bleeding increased, so we performed radiation therapy to the cervix in which achieved hemostasis. 2nd line treatment of carboplatin plus etoposide was done, but CT scan showed progression of disease. For 3rd line chemotherapy, Amrubicin was initiated. Although the use of pegfilgrastim, the patient presented febrile neutropenia and Grade 4 anemia making it difficult to continue the treatment. We used paclitaxel for 4th line treatment, but the patient was admitted to our hospital on Day17 due to right hemiparesis. CT scan showed multiple brain metastasis, so cranial irradiation was performed, but the patient died after 22 days of treatment in the hospital which was seven month after the first admission.
Conclusion: We present a case of SCUP which showed chemoresistant but radiosensitive behaviors.

キーワード

臓器別:NET(神経内分泌腫瘍)

手法別:化学療法

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