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Vol.53 No.6 contents | Japanese/English |
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- Case Report -
A Case of Pleomorphic Carcinoma with Tonsillar Metastasis Successfully Treated with S-1 Following Chemoradiation Therapy
Hajime Fujimoto1, Naoki Furuhashi1, Katsutoshi Adachi2, Hidenori Ibata1, Tetsu Kobayashi3, Osamu Taguchi31Department of Pulmonary Medicine, 2Department of Thoracic Surgery, National Hospital Organization Mie Central Medical Center, Japan, 3Department of Pulmonary and Critical Care Medicine, Clinical Medicine and Biomedical Science, Mie University Graduate School of Medicine, Japan
Background. Pleomorphic carcinoma is considered to be a histologic subset of lung cancer in the revised classification proposed by the WHO in 1999. Although treated as non-small cell lung cancer, the effects are usually limited and the prognosis is poor. On the other hand, metastasis of the palatine tonsils is very rare and considered to be a poor prognostic factor. We experienced a case of pleomorphic carcinoma with tonsillar metastasis that was very effectively treated with S-1 after chemoradiation therapy. Case. A 63-year-old male with an abnormal chest X-ray film shadow visited a general physician and was found to have a chest tumor that was diagnosed as non-small cell lung cancer on a needle biopsy. The patient was referred to our hospital where he underwent resection of the left upper lobe. A pathological examination revealed a histological tumor diagnosis of pleomorphic carcinoma, T2N0M0, stage IB. Tumor recurrence in the left tonsil occurred during uracil-tegafur (UFT) adjuvant chemotherapy, and we administered intravenous chemotherapy consisting of carboplatin and paclitaxel with concurrent radiotherapy; however, the treatment failed to shrink the tumor. Consequently, the patient received oral S-1 therapy, and the tumor disappeared seven months later. He has exhibited progression-free survival for four years and six months on S-1 therapy. Conclusions. In the present case, S-1 therapy achieved a long-term antitumor effect on chemoradiation-refractory pleomorphic carcinoma with tonsillar metastasis. Additional cases are needed to confirm the efficacy of S-1 in patients with pleomorphic carcinoma.
key words: Pleomorphic carcinoma, Tonsillar metastasis, S-1, Chemoradiation
Received: February 18, 2013
Accepted: August 22, 2013
JJLC 53 (6): 771-777, 2013
