Adenokarcinom s lepidickým způsobem růstu vykazuje kromě specifické morfologie i určitá klinická specifika, jako například častější výskyt u žen, nekuřáků a mladších pacientů a nižší citlivost ke konvenční cytostatické léčbě ve srovnání s ostatními podtypy nemalobuněčného karcinomu plic (NSCLC). Asi 10 % NSCLC exprimuje receptor pro epidermální růstový faktor (EGFR), který je prediktorem účinnosti biologické terapie. Popisujeme případ 33letého muže, léčeného ve spádovém zařízení pro těžkou levostrannou pneumonii. Až s odstupem 3 měsíců po přeléčení antibiotiky, po opakovaných radiologických kontrolách byl pacient odeslán na naše pracoviště k došetření pro přetrvávající infiltraci levé plíce. Biopsie prokázala mucinózní adenokarcinom s lepidickým způsobem růstu, již s přítomností metastáz v pravé plíci. I přes podání chemoterapie dochází k progresi onemocnění a pacient necelý rok od diagnostikování nemoci zmírá. Případ dokumentuje, že na karcinom plic je třeba myslet i v mladém věku a provádět důkladnou diagnostiku všech neobjasněných radiologických nálezů.
Adenocarcinoma with prominent lepidic spread presents, in addition to it´s specific morphology, with certain clinical characteristics as higher incidence in women, non-smokers and younger patiens and lower susceptibility to conventional cytostatik therapy in comparison to other subtypes of non-small cell lung carcinoma (NSCLC). About 10 % of NSCLC express receptor for epidermal growth faktor (EGFR), which is predictor of effectiveness to biologic therapy. We present a case of a 33 years old man, who was treated at the begining for left lung pneumonia. Just with the passage of 3 months, after antibiotic therapy and repeated radiology controls, the patient was sent to our workplace for further investigation for persistent infiltration of the left lung. Biopsy established mucinous adenocarcinoma with prominent lepidic spread, already with presence of metastasis in right lung. Despite the chemotherapy disease progresses and the patient is dying less than a year from the diagnosis. This case illustrates, that it´s important to think of lung carcinoma also in young age and carry out careful diagnostic of all unsolved radiologic findings.
- MeSH
- Adenocarcinoma * diagnosis etiology drug therapy therapy MeSH
- Adult MeSH
- ErbB Receptors diagnostic use MeSH
- Humans MeSH
- Carcinoma, Non-Small-Cell Lung * diagnosis etiology drug therapy MeSH
- Delayed Diagnosis * MeSH
- Pneumonia diagnosis etiology drug therapy MeSH
- Disease Progression MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Chemotherapy, Adjuvant MeSH
- Biological Therapy utilization MeSH
- ErbB Receptors diagnostic use MeSH
- Genes, erbB-2 drug effects MeSH
- Drug Evaluation MeSH
- Antibodies, Monoclonal, Humanized * administration & dosage therapeutic use toxicity MeSH
- Carcinoma drug therapy genetics MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- Neoplasm Metastasis drug therapy prevention & control MeSH
- Breast Neoplasms * diagnosis etiology drug therapy pathology therapy MeSH
- Disease-Free Survival MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- MeSH
- Biological Therapy MeSH
- ErbB Receptors diagnostic use genetics MeSH
- Protein Kinase Inhibitors metabolism therapeutic use MeSH
- Congresses as Topic MeSH
- Humans MeSH
- Carcinoma, Non-Small-Cell Lung drug therapy pathology MeSH
- Pulmonary Medicine * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- MeSH
- Adenocarcinoma * drug therapy genetics complications MeSH
- ErbB Receptors analysis diagnostic use genetics MeSH
- Humans MeSH
- Molecular Biology * methods MeSH
- Lung Neoplasms * drug therapy genetics MeSH
- Protein-Tyrosine Kinases antagonists & inhibitors pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Practice Guideline MeSH
- Keywords
- pertuzumab, T-DM1,
- MeSH
- Drug Resistance, Neoplasm MeSH
- Quinazolines pharmacology therapeutic use MeSH
- ErbB Receptors diagnostic use physiology MeSH
- Antibodies, Monoclonal, Humanized pharmacology adverse effects therapeutic use MeSH
- Lapatinib MeSH
- Humans MeSH
- Maytansine analogs & derivatives pharmacology therapeutic use MeSH
- Breast Neoplasms epidemiology drug therapy genetics therapy MeSH
- Prognosis MeSH
- Antineoplastic Agents pharmacology therapeutic use MeSH
- Receptor, ErbB-2 analysis diagnostic use drug effects MeSH
- Trastuzumab MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Biomarkers * analysis MeSH
- Quinazolinones administration & dosage adverse effects therapeutic use MeSH
- ErbB Receptors antagonists & inhibitors diagnostic use MeSH
- Genetic Testing methods utilization MeSH
- Precision Medicine utilization MeSH
- Clinical Trials as Topic MeSH
- Drug Therapy, Combination MeSH
- Congresses as Topic MeSH
- Humans MeSH
- Carcinoma, Non-Small-Cell Lung * diagnosis MeSH
- Predictive Value of Tests MeSH
- Check Tag
- Humans MeSH
- Keywords
- Iressa,
- MeSH
- Adenocarcinoma diagnosis genetics MeSH
- Biopsy utilization MeSH
- Early Diagnosis MeSH
- ErbB Receptors diagnostic use genetics MeSH
- Humans MeSH
- Mutation genetics MeSH
- Biomarkers, Tumor MeSH
- Lung Neoplasms diagnosis genetics MeSH
- Specimen Handling methods standards utilization MeSH
- Mass Screening methods utilization MeSH
- Check Tag
- Humans MeSH
