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Oxford Medical Case Reports Sep 2020A 69-year-old male presented with early stage non-small cell lung cancer in 2016. The tumor was resected; however, the patient experienced recurrence 2 years later and...
A 69-year-old male presented with early stage non-small cell lung cancer in 2016. The tumor was resected; however, the patient experienced recurrence 2 years later and subsequently received paclitaxel/carboplatin concurrently with radiotherapy. Within weeks of completing this treatment, he developed a symptomatic pancoast tumor secondary to disease progression and commenced second line nivolumab. Following the second dose of nivolumab, he developed acute unilateral right hearing loss. He commenced intravenous methylprednisolone followed by a slow taper of oral prednisolone. With steroids, he noted a gradual improvement in hearing, confirmed by audiology. Restaging imaging post-nivolumab demonstrated a complete metabolic response. Two prior cases have reported bilateral sensorineural hearing loss post-immune checkpoint inhibitor (ICI). We postulate the hearing impairment relates to the development of autoimmune inner ear disease. To our knowledge, this is the only case of a patient experiencing unilateral loss of hearing following an ICI.
PubMed: 32995031
DOI: 10.1093/omcr/omaa077 -
The Journal of Thoracic and... Dec 2023
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Pancoast Syndrome; Combined Modality Therapy
PubMed: 37831023
DOI: 10.1016/j.jtcvs.2023.09.024 -
Multimedia Manual of Cardiothoracic... Mar 2024We describe a rare procedure involving near-total robotic-assisted thoracoscopic surgery resection of a right posterior Pancoast tumour. Four ports and an assistant port...
We describe a rare procedure involving near-total robotic-assisted thoracoscopic surgery resection of a right posterior Pancoast tumour. Four ports and an assistant port were used. The DaVinci X system was used. The lobectomy was performed first to allow for adequate exposure to the apex and spine. The lateral aspect of ribs 1 to 4 was resected next, and the extrathoracic space was entered. Dissection proceeded through this space superiorly up to the level of the scapula and then posteriorly towards the spine. The second to the fifth ribs were dissected off the chest wall and resected medially off the spine at the rib heads. Further postero-superior exploration revealed the tumour to be invading the transverse process of the second rib, with ill-defined margins. Because of this development, and with the support of the spinal surgeons, a small high posterior thoracotomy was performed to complete the procedure and remove the specimen en bloc. The postoperative recovery was uneventful, and the patient was discharged on post-operative day 5. The final histological report confirmed a squamous non-small-cell lung cancer (pT3N0M0) with negative margins (R0). Asymptomatic recurrence was noted near the margin of the second rib resection posteriorly 1 year postoperatively and was successfully treated with radiotherapy.
Topics: Humans; Robotic Surgical Procedures; Thoracic Wall; Carcinoma, Non-Small-Cell Lung; Pancoast Syndrome; Lung Neoplasms; Thoracoscopy
PubMed: 38526520
DOI: 10.1510/mmcts.2023.063 -
Thoracic Cancer Nov 2022Surgical treatment of superior sulcus tumors (SSTs) is clinically challenging. Definitive chemoradiotherapy (CRT) is a standard treatment for SST. In operable cases,...
Surgical treatment of superior sulcus tumors (SSTs) is clinically challenging. Definitive chemoradiotherapy (CRT) is a standard treatment for SST. In operable cases, multimodal therapy (CRT followed by surgery) is another option, at least for experienced institutions. Immune checkpoint inhibitors (ICIs) have recently been developed, and several clinical trials have investigated definitive CRT followed by ICIs for consolidation or maintenance therapy of unresectable local advanced non-small cell lung cancer (NSCLC), including SSTs. Clinical studies of salvage surgery after CRT followed by ICIs are also ongoing. However, the clinical outcomes of salvage surgery after multimodal therapies and histopathological analyses of surgical specimens after such treatments remain unclear. Here, we report the case of a patient with SST comprising squamous cell carcinoma with invasion of the second to third rib and vertebrae who underwent salvage surgery after concurrent definitive CRT followed by the ICI durvalumab, and show the results of clinicopathological analyses of the resected specimen.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Chemoradiotherapy; Salvage Therapy; Pancoast Syndrome; Neoplasm Staging
PubMed: 36193676
DOI: 10.1111/1759-7714.14681 -
Clinical Case Reports Apr 2024PET-driven SBRT plus pembrolizumab as first-line therapy against pleomorphic Pancoast cancer appears beneficial, probably due to high equivalent doses of SBRT on...
PET-driven SBRT plus pembrolizumab as first-line therapy against pleomorphic Pancoast cancer appears beneficial, probably due to high equivalent doses of SBRT on photopenic necrotic core and synergic immune system stimulation of immunoradiotherapy.
PubMed: 38585585
DOI: 10.1002/ccr3.8633 -
Journal Der Deutschen Dermatologischen... Jan 2020
Topics: Female; Horner Syndrome; Humans; Magnetic Resonance Imaging; Melanoma; Middle Aged; Neoadjuvant Therapy; Neoplasms, Unknown Primary; Pancoast Syndrome; Protein Kinase Inhibitors; Proto-Oncogene Proteins B-raf; Tomography, X-Ray Computed; Vemurafenib
PubMed: 31742889
DOI: 10.1111/ddg.13983