전이성 병소에 의해 발생한 급성 충수염의 천공으로 진단된 전신병기 소세포폐 암 1예
A Case of Extensive Stage Small Cell Lung Cancer Presenting as an Acute Appendicitis with Perforation
최문한 (순천향의대)
박승식 (순천향의대 내과)
박성우 (순천향대학교)
김기업 (순천향대학교)
장안수 (순천향대학교)
박춘식 (순천향대학교 의과대학 호흡기 및 알레르기 내과학교실, 폐 및 호흡기질환 유전체센터)
임철완 (순천향대학교)
고은석 (순천향대학교)
백상현 (순천향대학교)
김도진 (순천향대학교)
- 다운로드 수
- 조회수
초록
본 증례에서 환자는 폐렴 치료 중 갑자기 발생한 복통을 주소로 급성 충수염을 진단받고 수술을 시행 받았다. 그 후 조직 검사 결과 소세포암으로 진단되었고 폐병변에 대해 추가적인 검사 결과 소세포폐암이 진단된 경우이다. 저자들은 소세포폐암의 충수 전이를 국내에서 처음으로 경험하여 문헌고찰과 함께 보고하는 바이다.
- keywords
- Appendix, Metastasis, Small cell carcinoma
Abstract
The incidence of appendiceal metastatic cancer is quite low. In particular, in small cell lung cancer, there is a very low incidence of a metastasis to the appendix. A 75-years old man with right lower quadrant pain, cough and sputum was transferred to our hospital. Abdominal CT revealed acute appendicitis with a perforation. The patient underwent surgery. The frozen sections of the tissue obtained during surgery, indicated a malignancy, but a right hemicolectomy was not performed due to the patient’s poor general condition. The histology findings of the appendix were identified as a small cell carcinoma. The abdominal CT scan and chest x-ray at admission day showed a mass in the right lower lobe, and a further evaluation of the lesion was performed including positron emission tomography and flexible bronchoscopy with a biopsy. The pathology findings of the lung mass were also small cell lung cancer. The specimens from both sites stained positive for cytokeratin, cluster designation 56, synaptophysin, chromogranin-A and thyroid transcription factor 1. It was concluded that the appendiceal small cell cancer originated from the lung.
- keywords
- Appendix, Metastasis, Small cell carcinoma
참고문헌
1. Cohen MH, Matthews MJ. Small cell bronchogenic carcinoma: a distinct clinicopathologic entity. Semin Oncol 1978;5:234-43.
2. Sridhar KS, Hussein AM, Thurer RJ. Evolving role of surgical treatment in limited-disease small cell lung carcinoma. J Surg Oncol 1989;40:155-61.
3. Johnson BE. Management of small cell lung cancer. Clin Chest Med 2002;23:225-39.
4. Pang LC. Metastasis-induced acute appendicitis in small cell bronchogenic carcinoma. South Med J 1988;81:1461-2.
5. Goldstein EB, Savel RH, Walter KL, Rankin LF, Satheesan R, Lehman HE, et al. Extensive stage small cell lung cancer presenting as an acute perforated appendix: case report and review of the literature. Am Surg 2004;70:706-9.
6. Levchenko AM, Vasechko VN, Erusalimskiĭ EL. Metastasis of small-cell lung cancer to the appendix. Klin Khir 1985;5:56-7.
7. Park IJ, Yu CS, Kim HC, Kim JC. Clinical features and prognostic factors in primary adenocarcinoma of the appendix. Korean J Gastroenterol 2004;43:29-34.
8. Cortina R, McCormick J, Kolm P, Perry RR. Management and prognosis of adenocarcinoma of the appendix. Dis Colon Rectum 1995;38:848-52.
9. Ryo H, Sakai H, Ikeda T, Hibino S, Goto I, Yoneda S, et al. Gastrointestinal metastasis from lung cancer. Nihon Kyobu Shikkan Gakkai Zasshi 1996;34:968-72.
10. Lobins R, Floyd J. Small cell carcinoma of unknown primary. Semin Oncol 2007;34:39-42.
11. Lau SK, Luthringer DJ, Eisen RN. Thyroid transcription factor-1: a review. Appl Immunohistochem Mol Morphol 2002;10:97-102.
12. Ordonez NG. Value of thyroid transcription factor-1 immunostaining in distinguishing small cell lung carcinomas from other small cell carcinomas. Am J Surg Pathol 2000;24:1217-23.
13. Fletcher MS. Gastric perforation secondary to metastatic carcinoma of the lung: a case report. Cancer 1980;46:1879-82.
14. Morgan MW, Sigel B, Wolcott MW. Perforation of a metastatic carcinoma of the jejunum after cancer chemotherapy. Surgery 1961;49:687-9.
15. Shen YY, Shiau YC, Wang JJ, Ho ST, Kao CH. Whole-body 18F-2-deoxyglucose positron emission tomography in primary staging small cell lung cancer. Anticancer Res 2002;22:1257-64.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수