ʻO ka maʻi maʻi ʻaʻai māmā liʻiliʻi metastatic-01

I Iune 2022, ua hana ʻia kahi maʻi kāne he 65 mau makahiki i kahi hoʻokolohua kino maʻamau, a ua hōʻike ʻia kahi CT scan i kahi nodule ma lalo o ka pleura ma ka ʻaoʻao ʻākau o luna o ka māmā. I Ianuali 2023, ua hoʻomaka ka mea maʻi e ʻike i nā hōʻailona e like me ka hoarseness, cough, a me ka pōkole o ka hanu. Ma Mei 2023, ua ʻoi aku ka ʻino o kona ʻū a me ka pōkole o ka hanu. Ua hōʻike ʻo Scans i ka piʻi nui ʻana o ka hana metabolic ma ka nodule o ka māmā lobe akau, he manaʻo nui no ka maʻi kanesa. Hoʻohui ʻia, ʻike ʻia ka hoʻonui ʻana i ka hana metabolic i loko o nā puʻupuʻu lymph he nui, me ka ʻāpana supraclavicular ʻākau, mediastinum, trachea, ʻāpana para-aortic, a me ka vena cava inferior. Ua hōʻike pū nā kiʻi i nā mānoanoa nodular he nui i ka pleura ʻākau me ka hoʻonui ʻana i ka hana metabolic. Ua hōʻike ʻia nā hopena o ka hoʻokolokolo ʻana i ka metastasis pleural kūpono me ka effusion pleural, a ua hōʻoia ʻia ka ʻike hope loa o ka metastatic small cell lung cancer ma o ka hoʻokolokolo pathological, imaging, a me immunohistochemistry. Ua loaʻa i ka mea maʻi ka lāʻau lapaʻau.

ʻElima mahina ma hope mai, ua emi loa ka nui o ka maʻi ʻaʻai, a ua nalowale ka hapa nui o nā maʻi metastatic. ʻO ke ʻano o ka lāʻau lapaʻau ʻo ia ka immunotherapy mua o atezolizumab i hui pū ʻia me ka anlotinib targeted therapy. Hāʻawi ʻia ʻo Atezolizumab ma kahi ʻano o 1200 mg i ka lā mua, a ma hope o kahi hoʻomaha i ka mālama ʻana. Ua hāʻawi waha ʻia ʻo Anlotinib ma kahi ʻano o 10 mg i kēlā me kēia lā no ʻelua mau pule, ukali ʻia e kahi manawa hoʻomaha ʻehiku lā, e hana ana i kahi pōʻai lāʻau 21 lā. Ma hope o 15 mau manawa o ka radiotherapy, ua hōʻike ʻia nā kiʻi CT i kahi hōʻemi nui o ka ʻeha ma ka māmā ʻākau, a ua emi nui pū ka mediastinum a me nā lymph nodes. Ua hōʻike ʻia kahi CT scan ma Sepatemaba 10, 2023, i nā loli maikaʻi: ka emi ʻana o ka hoʻoheheʻe ʻana o ka pleural akau, ka emi ʻana o ka mānoanoa pleural ʻākau, a me ka liʻiliʻi liʻiliʻi liʻiliʻi a me nā puʻupuʻu lymph supraclavicular liʻiliʻi, me ka hoʻonui ʻole ʻana o nā puʻu lymph abdominal a retroperitoneal.

Hoʻohālikelike ʻia me ka scan ma Mei 7, 2023, ʻo ka scan ma ʻOkakopa 10, 2023, ua hōʻike i kahi hōʻemi nui o ka maʻi ʻaʻai. Ma ke ʻano kikoʻī, ua ʻike ʻia ka emi ʻana ma ka nodule ma ka lobe luna ʻākau a ma nā ʻōpū lymph kokoke i ka trachea, nā kīʻaha koko, ka ʻāpana para-aortic, a me ka vena cava inferior. ʻO ka mānoanoa nodular i ʻike mua ʻia ma ka peritoneum kūloko, ka paia o ka umauma mua ʻākau, a me ka 11th-12th intercostal space ua emi nui. Eia hou, ua emi loa ka aka nodular ha'aha'a ha'aha'a ma ka 'i'o po'ohiwi akau. Hōʻike kēia mau hopena i ka maikaʻi o ka mālama ʻana i ka ʻōnaehana, me ka hapa nui o nā maʻi metastatic e nalowale ana a me nā ʻeha i koe e emi nui. Hōʻike nā loiloi kiʻi i ka holomua o ke ʻano o ka mālama ʻana, a aia ka maʻi koko i kēia manawa i kahi manawa kala ʻia.