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Successful treatment of persistent bronchorrhea by gefitinib in a case with Recurrent Bronchioloalveolar Carcinoma: a case report.

Takao M, Inoue K, Watanabe F, Onoda K, Shimono T, Shimpo H, Yada I - World J Surg Oncol (2003)

Bottom Line: Multiple pulmonary metastases in right lung were found one year after operation.Thereafter, she has been symptom-free and shows good partial response on repeat scan after 9 months of oral gefitinib.Although it is not possible to comment on whether the improvement came from tumor cell death itself or suppressive effect of mucin synthesis by the epidermal growth factor receptor-tyrosine kinase inhibitory action.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. takao@clin.medic.mie-u.ac.jp

ABSTRACT
BACKGROUND: Bronchorrhea is one of late complaints in patients with bronchioloalveolar carcinoma (BAC) and hampers their quality of life. Although an effective treatment for bronchorrhea in these patients has not been established, recently we have treated effectively one case of persistent bronchorrhea associated with clinical recurrent BAC with gefitinib (ZD1839, 'Iressa trade mark '; AstraZeneca Japan; Osaka, Japan). CASE PRESENTATION: A 63-year-old Japanese female had undergone left pneumonectomy with radical lymph node dissection (ND2a) for diffuse type bronchioloalveolar carcinoma originated in left lower lobe. Multiple pulmonary metastases in right lung were found one year after operation. Pulmonary metastatic lesion has grown and she complained of progressive symptoms of massive watery sputum and dyspnea, four years after operation. Although her symptom was getting worse in spite of routine treatment, it completely disappeared within 2 weeks of starting oral gefitinib. Thereafter, she has been symptom-free and shows good partial response on repeat scan after 9 months of oral gefitinib. CONCLUSIONS: The dramatic remission of persistent bronchorrhea by gefitinib in the presented case suggests that gefitinib might be a promising option for bronchioloalveolar carcinoma, particularly in cases with severe bronchorrhea. Although it is not possible to comment on whether the improvement came from tumor cell death itself or suppressive effect of mucin synthesis by the epidermal growth factor receptor-tyrosine kinase inhibitory action.

No MeSH data available.


Related in: MedlinePlus

Chest CT scan taken on June 25, 2002 showing the lesion.
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Figure 1: Chest CT scan taken on June 25, 2002 showing the lesion.

Mentions: A 63-year-old Japanese female underwent left pneumonectomy with radical lymph node dissection (ND2a) on March 16, 1998, for diffuse type BAC originating in left lower lobe, which was p-T2N0M1, stage IV disease with intrapulmonary metastasis to left upper lobe (pm2). She was thereafter followed with oral UFT (5-FU derivative "tegafur" and uracil at a molar ratio of 1:4; Taiho Pharmaceutical Co., Ltd., Tokyo, Japan) at 400 mg/day, because she refused to be treated with adjuvant intravenous chemotherapy. On March 12, 1999, multiple small pulmonary metastases in the right lung (S5 and S6) were found on a follow-up computerized tomographic scanning (CT), although she was asymptomatic. As these pulmonary metastases have grown slowly but constantly, oral etoposide 25 mg/day was added since April 10, 2001, she refused the usage of intravenous anti-cancer agents. She gradually developed productive cough and dyspnea since July 2001. Chest CT on June 25, 2002 revealed multiple pneumonia-like consolidations on each lobe of the right lung (Fig. 1).


Successful treatment of persistent bronchorrhea by gefitinib in a case with Recurrent Bronchioloalveolar Carcinoma: a case report.

Takao M, Inoue K, Watanabe F, Onoda K, Shimono T, Shimpo H, Yada I - World J Surg Oncol (2003)

Chest CT scan taken on June 25, 2002 showing the lesion.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC183862&req=5

Figure 1: Chest CT scan taken on June 25, 2002 showing the lesion.
Mentions: A 63-year-old Japanese female underwent left pneumonectomy with radical lymph node dissection (ND2a) on March 16, 1998, for diffuse type BAC originating in left lower lobe, which was p-T2N0M1, stage IV disease with intrapulmonary metastasis to left upper lobe (pm2). She was thereafter followed with oral UFT (5-FU derivative "tegafur" and uracil at a molar ratio of 1:4; Taiho Pharmaceutical Co., Ltd., Tokyo, Japan) at 400 mg/day, because she refused to be treated with adjuvant intravenous chemotherapy. On March 12, 1999, multiple small pulmonary metastases in the right lung (S5 and S6) were found on a follow-up computerized tomographic scanning (CT), although she was asymptomatic. As these pulmonary metastases have grown slowly but constantly, oral etoposide 25 mg/day was added since April 10, 2001, she refused the usage of intravenous anti-cancer agents. She gradually developed productive cough and dyspnea since July 2001. Chest CT on June 25, 2002 revealed multiple pneumonia-like consolidations on each lobe of the right lung (Fig. 1).

Bottom Line: Multiple pulmonary metastases in right lung were found one year after operation.Thereafter, she has been symptom-free and shows good partial response on repeat scan after 9 months of oral gefitinib.Although it is not possible to comment on whether the improvement came from tumor cell death itself or suppressive effect of mucin synthesis by the epidermal growth factor receptor-tyrosine kinase inhibitory action.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. takao@clin.medic.mie-u.ac.jp

ABSTRACT
BACKGROUND: Bronchorrhea is one of late complaints in patients with bronchioloalveolar carcinoma (BAC) and hampers their quality of life. Although an effective treatment for bronchorrhea in these patients has not been established, recently we have treated effectively one case of persistent bronchorrhea associated with clinical recurrent BAC with gefitinib (ZD1839, 'Iressa trade mark '; AstraZeneca Japan; Osaka, Japan). CASE PRESENTATION: A 63-year-old Japanese female had undergone left pneumonectomy with radical lymph node dissection (ND2a) for diffuse type bronchioloalveolar carcinoma originated in left lower lobe. Multiple pulmonary metastases in right lung were found one year after operation. Pulmonary metastatic lesion has grown and she complained of progressive symptoms of massive watery sputum and dyspnea, four years after operation. Although her symptom was getting worse in spite of routine treatment, it completely disappeared within 2 weeks of starting oral gefitinib. Thereafter, she has been symptom-free and shows good partial response on repeat scan after 9 months of oral gefitinib. CONCLUSIONS: The dramatic remission of persistent bronchorrhea by gefitinib in the presented case suggests that gefitinib might be a promising option for bronchioloalveolar carcinoma, particularly in cases with severe bronchorrhea. Although it is not possible to comment on whether the improvement came from tumor cell death itself or suppressive effect of mucin synthesis by the epidermal growth factor receptor-tyrosine kinase inhibitory action.

No MeSH data available.


Related in: MedlinePlus