经支气管镜高频电刀联合冷冻治疗结肠癌支气管内转移一例并文献复习

Endobronchial Metastasis From Colon Cancer Treated by High-frequency Electrotome Excision Combined With Cryotherapy via Bronchoscope: One Case Report and Literatures Review

目的介绍1例结肠癌支气管内转移患者经支气管镜高频电刀联合冷冻治疗的效果。方法患者既往患有结肠癌,此次经肺CT和纤维支气管镜检查发现右肺上叶管口开口处可见一不规则有蒂的息肉样新生物不完全阻塞管口,采用支气管镜介导下的高频电刀切除病灶,基底部联合冷冻治疗。结果术后病理诊断为腺癌,结肠癌支气管内转移。1周后复查肺CT示右主支气管和右肺上叶开口间嵴处类圆形结节病灶消失;3个月后纤维支气管镜检查示右肺上叶开口间嵴处未见异常。结论气管内转移瘤采用高频电切和冷冻治疗,效果良好,而且损伤小、费用低,是此类疾病治疗的一种新的有效选择。

Objective To review the efficacy of high-frequency electrotome excision combined with cryotherapy via bronchoscope in a case of endobronchial metastases from colon cancer. Methods The patient had colon cancer before. By lung CT scan and fiberoptic bronchoscopy,a neoplasm in an irregular,pedicled and polypoid form was found at the mouth of the nozzle of superior lobe of right lung. High-frequency electrotome was used to excise the neoplasm via bronchoscope,and then cryotherapy was conducted in the basilar part. Results Through the pathological diagnosis following surgery,the lesion was diagnosed as adenocarcinoma,which was endobronchial metastasis from colon cancer. A week after the surgery,lung CT scan showed the quasi -circular nodule nidus at the nozzle ridge of superior lobe of right lung disappear;three months later,no abnormality was noted at the nozzle ridge of superior lobe of right lung by fiberoptic bronchoscopy. Conclusion High-frequency electrotome exercison combined with cryotherapy has a good efficacy in the treatment of metastatic tumor in trachea. It leads to minor injuries and costs less,and is a good and effective choice for the treatment alike.