Metastatike ntoya ya kanseri y'ibihaha-01

Muri kamena 2022, umurwayi wumugabo wimyaka 65 yipimishije bisanzwe, hanyuma CT scan yerekanaga node munsi ya pleura mugice cyiburyo cyibihaha. Muri Mutarama 2023, umurwayi yatangiye kubona ibimenyetso nko gutontoma, gukorora, no guhumeka neza. Muri Gicurasi 2023, inkorora ye no guhumeka neza byariyongereye. Scan yerekanaga ibikorwa byiyongera cyane muburyo bwo hejuru bwibihaha hejuru yibihaha, byerekana kanseri y'ibihaha. Byongeye kandi, ibikorwa bya metabolike byiyongereye byagaragaye muri lymph node nyinshi, harimo akarere ka supraclavicular iburyo, mediastinum, trachea, agace ka para-aortic, na vena cava yo hasi. Amashusho yanagaragaje umubyimba mwinshi wa nodular muri pleura iburyo hamwe no kongera ibikorwa bya metabolike. Ibisubizo by'ibizamini byagaragaje metastasis iburyo hamwe na effural effusion, kandi isuzuma rya nyuma rya kanseri y'ibihaha ntoya ya kanseri y'ibihaha ryemejwe binyuze mu gusuzuma indwara, gufata amashusho, hamwe na immunohistochemie. Umurwayi yahise yivuza cyane.

Nyuma y'amezi atanu, ingano y'ibibyimba yari yagabanutse cyane, kandi ibikomere byinshi metastatike byari byarazimiye. Uburyo bwo kuvura bwarimo atezolizumab yambere yubuvuzi hamwe na anlotinib igamije kuvura. Atezolizumab yatanzwe ku kigero cya 1200 mg kumunsi wambere, hakurikiraho guhagarara mukuvura. Anlotinib yahawe umunwa ku gipimo cya mg 10 buri munsi mu byumweru bibiri bikurikiranye, hanyuma ikurikirwa n’ikiruhuko cy’iminsi irindwi, ikora uburyo bwo kuvura iminsi 21. Nyuma yamasomo 15 ya radiotherapi, amashusho ya CT yerekanaga igabanuka rikabije ryibisebe mu bihaha byiburyo, kandi mediastinum iburyo na lymph node nabyo byagabanutse cyane. Ubushakashatsi bwakorewe kuri CT ku ya 10 Nzeri 2023, bwerekanye impinduka nziza: kugabanuka kw'iburyo bwiza bwo kugabanuka, kugabanuka kwijimye kw'iburyo, hamwe na lymph node ntoya, hamwe no kwaguka kwa lymph node na retroperitoneal lymph node.

Ugereranije na scan yo ku ya 7 Gicurasi 2023, scan yo ku ya 10 Ukwakira 2023, yerekanye ko igabanuka ryagabanutse cyane. By'umwihariko, kugabanuka byagaragaye muri node mu gice cyo hejuru cyo hejuru no mu mitsi myinshi ya lymph hafi ya trachea, imiyoboro y'amaraso, agace ka para-aortic, na vena cava yo hasi. Ubunini bwa nodular bwagaragaye mbere muri peritoneum yaho, urukuta rw'imbere rw'igituza, n'umwanya wa 11-12 wa intercostal wari wagabanutse cyane. Ikigeretse kuri ibyo, igicucu gike cyane cya nodular igicucu mumitsi yigitugu cyiburyo nacyo cyari cyaragabanutse cyane. Ibisubizo byerekana ko uburyo bwo kuvura sisitemu bwagize akamaro, ibikomere byinshi metastatike bikabura kandi ibikomere bisigaye bikagabanuka cyane. Isuzuma ryerekana amashusho ryerekana ko uburyo bwo kuvura bwagenze neza, kandi ikibyimba ubu kiri muburyo bwo kuvura igice.