Résumé
Case: A 62-year-old woman underwent high anterior resection and partial lobectomy for colon cancer and lung metastasis, respectively, and postoperative chemotherapy. During the follow-up period, she visited the Department of Otolaryngology at our hospital, complaining of expectoration of a mass. Laryngeal fiberscopy showed no abnormality, but thoracic computed tomography revealed nodular lesions protruding into the bronchial lumen. Bronchoscopy confirmed the presence of multiple granular nodules protruding from the bronchial wall. The nodules had a polyp-like appearance and were easily dissected or detached. Anti-cancer drug therapy was initiated for endobronchial metastases from colorectal cancer diagnosed in transbronchial biopsy. Conclusion: This was a rare case of endobronchial metastases that were discovered after expectoration of tumor masses. Bronchoscopic findings were extremely unusual, showing multiple tumors that were easily detached because of their extremely weak connection to the bronchial wall. The findings suggest that it is important to consider endobronchial metastasis from colorectal cancer and perform early diagnostic imaging and bronchoscopy when patients present with recurrent expectoration of masses after surgery for colon cancer.
Résumé
Recently, in order to make chemotherapy, safer and more effective various forms of intervention by pharmacists are needed. In this paper, we report our experience in intervening in the administration of gefitinib to a patient with dysphagia. Chemotherapy with an intravenous drip injection to the 58 year-old woman admitted to our hospital for non-small cell lung cancer (NSCLC) was withdrawn due to severe pancytopenia after the first cycle of pharamcotherapy. Then, as an altermative, oral medication, of gefitinib was suggested by medical doctors. However, the oral administration was inappropriate to the condition of the patient. She was unable to keep taking gefitinib pills because she had been suffering from a progressive swallowing disturbance due to progressive non-small cell lung cancer. Thus, we proposed another oral administration method in which gefitinib was resuspended in thickening agents. This method made it possible for the patient to take gefitinib without any adverse events until the day before the patient died.