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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 December 3,2002, 8 weeks after gefitinib was started.
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Figure 2: Chest CT scan taken on December 3,2002, 8 weeks after gefitinib was started.

Mentions: Although sputum cytology failed to prove a definitive pathological diagnosis of recurrence, her symptom and radiological findings had never improved by antibiotics, steroid and with interruption of oral anti-cancer therapy. Because she had complained of progressive symptoms of massive watery sputum and dyspnea, she was started on oral gefitinib 250 mg/day on October 8, 2002. Her symptoms dramatically improved along with disappearance of the abnormal diffuse shadow on chest radiograph two week later. On December 3, 2002, 8 weeks after gefitinib was started, almost complete remission of diffuse pulmonary cloudy shadow was confirmed on chest CT (Fig. 2).


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 December 3,2002, 8 weeks after gefitinib was started.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 2: Chest CT scan taken on December 3,2002, 8 weeks after gefitinib was started.
Mentions: Although sputum cytology failed to prove a definitive pathological diagnosis of recurrence, her symptom and radiological findings had never improved by antibiotics, steroid and with interruption of oral anti-cancer therapy. Because she had complained of progressive symptoms of massive watery sputum and dyspnea, she was started on oral gefitinib 250 mg/day on October 8, 2002. Her symptoms dramatically improved along with disappearance of the abnormal diffuse shadow on chest radiograph two week later. On December 3, 2002, 8 weeks after gefitinib was started, almost complete remission of diffuse pulmonary cloudy shadow was confirmed on chest CT (Fig. 2).

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