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Title: 気管支内転移により有瘻性膿胸となった腎細胞癌の1例
Other Titles: A Case of Pleural Empyema with Fistula Caused by Endobronchial Metastasis of Renal Cell Carcinoma
Authors: 金城, 友紘  KAKEN_name
田中, 亮  KAKEN_name
中井, 康友  KAKEN_name
山本, 顕生  KAKEN_name
山本, 致之  KAKEN_name
永原, 啓  KAKEN_name
中山, 雅志  KAKEN_name
垣本, 健一  KAKEN_name
西村, 和郎  KAKEN_name
Author's alias: KANAKI, Tomohiro
NAKAI, Yasutomo
YAMAMOTO, Yoshiyuki
Keywords: Renal cell carcinoma
Endobronchial metastasis
Empyema with fistula
Issue Date: 30-Apr-2022
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 68
Issue: 4
Start page: 113
End page: 116
Abstract: A 52-year-old man complained of asymptomatic gross hematuria and cough. Chest and abdominal computed tomography (CT) revealed a right renal tumor, mediastinal lymph node metastasis, and right endobronchial metastasis. The right endobronchial metastasis was causing obstructive atelectasis in the lower lobe of the right lung. After tumor biopsy, the pathological diagnosis was clear cell renal cell carcinoma. Combination immunotherapy with ipilimumab and nivolumab was initiated, but CT showed enlargement of the metastatic lesion and lung abscess after two courses of treatment. The therapy was then switched to axitinib. Six days after initiation of axitinib, the lung abscess perforated into the pleural cavity, which resulted in the formation of pleural empyema with fistula. Ten days after initiation of axitinib, obstruction of the bronchus was relieved due to shrinkage of the right endobronchial metastasis, which resulted in development of a pneumothorax. Placement of a thoracic drainage tube and administration of an antimicrobial agent improved the pneumothorax and inflammatory response, but the drainage tube could not be removed. Long-term insertion of the thoracic drainage tube considerably diminished the patient's quality of life, and after 4 months, he was transferred to another hospital to receive the best supportive care.
Description: 本論文の要旨は第243回日本泌尿器科学会関西地方会において発表した.
Rights: 許諾条件により本文は2023/05/01に公開
DOI: 10.14989/ActaUrolJap_68_4_113
PubMed ID: 35613899
Appears in Collections:Vol.68 No.4

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