- 期刊
Patient with Small Cell Lung Carcinoma-Induced Acute Pancreatitis: A Case Report
小細胞肺癌引起的急性胰臟炎－病例報告
摘要
胰臟惡性轉移佔所有轉移性惡性腫瘤的比率高達40%。臨床經驗有多種急性腫瘤會轉移到胰臓，包括：Hedgkin's林巴癌、前列腺癌、乳癌、腎細胞癌、冑癌及肺癌。上述腫瘤中最常引起急性胰臟炎的惡性腫瘤是小細胞肺癌。但是為一罕見的情況約有3-7%，其癒後很差。致病機轉包括腫瘤侵犯引起的破裂或血管壓迫，胰管因胰臟旁之林巴結轉移引起的壓迫或阻塞。 藉由非侵入性的方法鑑別急性胰臓炎是否由轉移性惡性腫瘤所引起是幾乎不可能的。臨床上可先排除其他致病因素，包括：藥物、酒精、高血脂症、膽結石等。轉移性腫瘤所引起的急性胰臟炎以傳統支持性治療法之效果不佳或許可提供一診斷線索。有些病志接受化學治療可以獲得存活的好處。 本篇報告提出一位69歲男性罹患復發性小細胞肺癌病發急性胰臟炎。臨床症狀包括急性腹痛、胰澱粉酶、脂肪酶上升。經由腹部電腦斷層掃描發現胰臟腫大併有非約質腫塊。起初本病患只接受傳統支援性治療方式但臨床症狀改善並不明顯。因此嘗試以化學治療來改善急性胰臟炎的症狀。治療後不僅其臨床症狀迅速改善並且存活超過四週以上。
並列摘要
Pancreatic metastases are found in up to 40% of patients with disseminated malignancy. Metastases-induced acute pancreatitis is a rare condition in 3-7% of these patients, and has a poor prognosis. Differentiating metastases-induced acute pancreatitis from the usual forms of acute pancreatitis is almost impossible using noninvasive methods, though the lack of response to conventional management provides a clue. Chemotherapy may provide a survival benefit in some patients, and should be considered on an individual basis. Herein, we describe the case of a 69-year-old man with recurrent small cell lung cancer, which induced acute pancreatitis. This patient initially received conservative treatment without significant clinical improvement. Chemotherapy then was attempted, and the patient survived for over 4 weeks after this treatment, showing a clinical improvement of the pancreatitis
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