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Corticosteroid-induced Cushingoid Appearance in Myasthenia Gravis. 重症肌无力中皮质类固醇诱导的库欣样外观。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5678-25
Akiyuki Uzawa, Shigeaki Suzuki, Satoshi Kuwabara, Manato Yasuda, Hiroyuki Akamine, Yosuke Onishi, Yukiko Ozawa, Naoki Kawaguchi, Tomoya Kubota, Masanori P Takahashi, Yasushi Suzuki, Genya Watanabe, Takashi Kimura, Takamichi Sugimoto, Makoto Samukawa, Naoya Minami, Masayuki Masuda, Shingo Konno, Yuriko Nagane, Kimiaki Utsugisawa
{"title":"Corticosteroid-induced Cushingoid Appearance in Myasthenia Gravis.","authors":"Akiyuki Uzawa, Shigeaki Suzuki, Satoshi Kuwabara, Manato Yasuda, Hiroyuki Akamine, Yosuke Onishi, Yukiko Ozawa, Naoki Kawaguchi, Tomoya Kubota, Masanori P Takahashi, Yasushi Suzuki, Genya Watanabe, Takashi Kimura, Takamichi Sugimoto, Makoto Samukawa, Naoya Minami, Masayuki Masuda, Shingo Konno, Yuriko Nagane, Kimiaki Utsugisawa","doi":"10.2169/internalmedicine.5678-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5678-25","url":null,"abstract":"<p><p>Objective Corticosteroids are the primary immunosuppressants used to treat myasthenia gravis (MG). Their side effects, including Cushingoid appearance, are well documented. However, the precise relationship between corticosteroid usage and Cushingoid appearance has not been fully explored. Methods This study investigated the frequency and severity of Cushingoid appearance and their relationships with corticosteroid use. In total, 1,321 consecutive patients with MG who were prednisolone users, enrolled in the Japanese MG registry study 2021, were examined, and the severity of Cushingoid appearance was evaluated using the Cushingoid appearance index. Results The rates of Cushingoid appearance at survey and peak were 36.4% and 62.0%, respectively. Multivariate regression analyses revealed that the current Cushingoid appearance index was correlated with the current prednisolone dose, duration of prednisolone dose >10 mg/day, and female sex. The risk of Cushingoid appearance was classified according to prednisolone dose and duration using a decision tree. The Cushingoid appearance index significantly decreased with decreases in the prednisolone dose during the 6 years of follow-up. The Cushingoid appearance index was also significantly correlated with the MG-Quality of Life 15-revised score. Conclusion This study elucidated the relationship between corticosteroid treatment and Cushingoid appearance in MG, suggesting that the high-dose and long-term use of corticosteroids should be avoided to improve the patient quality of life.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemorrhagic Pneumonia due to Stenotrophomonas maltophilia in a Patient with Systemic Lupus Erythematosus-associated Thrombotic Microangiopathy under Immunosuppressive Therapy. 免疫抑制治疗系统性红斑狼疮相关血栓性微血管病患者嗜麦芽窄养单胞菌所致出血性肺炎1例。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5681-25
Takuya Yasuda, Noboru Hagino
{"title":"Hemorrhagic Pneumonia due to Stenotrophomonas maltophilia in a Patient with Systemic Lupus Erythematosus-associated Thrombotic Microangiopathy under Immunosuppressive Therapy.","authors":"Takuya Yasuda, Noboru Hagino","doi":"10.2169/internalmedicine.5681-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5681-25","url":null,"abstract":"<p><p>A 61-year-old woman with systemic lupus erythematosus was admitted with persistent pericardial effusion. Blood tests suggested thrombotic microangiopathy (TMA). Treatment with methylprednisolone, fresh-frozen plasma, and rituximab was initiated after tacrolimus discontinuation. A renal biopsy revealed endothelial injury and glomerular capillary thrombi, consistent with TMA. The patient developed severe anemia and bilateral lung opacities. Bronchoalveolar lavage revealed alveolar hemorrhaging and Stenotrophomonas maltophilia, indicating hemorrhagic pneumonia. Although chest radiography showed improvement with minocycline and levofloxacin treatment, she ultimately succumbed to Candida albicans sepsis. Hemorrhagic pneumonia-causing pathogens, such as S. maltophilia, should be considered when alveolar hemorrhaging occurs during immunosuppressive therapy.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disseminated Nontuberculous Mycobacterial Infection Following Cerebral Shunt Infection Caused by Mycobacterium fortuitum: A Case Report and Literature Review. 偶发分枝杆菌所致脑分流感染后播散性非结核分枝杆菌感染1例报告并文献复习。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.4267-24
Mio Toyama-Kousaka, Masahiro Shinoda, Takushi Yoshida, Marino Fujisaki, Takashi Sato, Miwa Morikawa, Hidenori Takahashi, Nagashige Shimada, Hiroaki Takei, Masaharu Shinkai
{"title":"Disseminated Nontuberculous Mycobacterial Infection Following Cerebral Shunt Infection Caused by Mycobacterium fortuitum: A Case Report and Literature Review.","authors":"Mio Toyama-Kousaka, Masahiro Shinoda, Takushi Yoshida, Marino Fujisaki, Takashi Sato, Miwa Morikawa, Hidenori Takahashi, Nagashige Shimada, Hiroaki Takei, Masaharu Shinkai","doi":"10.2169/internalmedicine.4267-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4267-24","url":null,"abstract":"<p><p>A 64-year-old, previously healthy woman underwent repeated shunt removal and reinsertion for shunt dysfunction due to hydrocephalus. M. fortuitum was detected in the culture solution at the end of the removed lumboperitoneal shunt approximately one year before the diagnosis; however, the result was considered to represent environmental contamination. The patient was hospitalized because of a high-grade fever, and M. fortuitum was detected in two blood cultures and a cerebrospinal fluid culture. We diagnosed the patient with disseminated nontuberculous mycobacterial infection due to M. fortuitum and removed the ventriculoatrial shunt. Multiple antimicrobial agents (imipenem/cilastatin, linezolid, ciprofloxacin, and trimethoprim/sulfamethoxazole) were administered for approximately two months, and the symptoms improved.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exogenous Lipoid Pneumonia Induced by the Excessive Use of Menthol-containing Nasal Inhalers and Subsequent Acute Hypersensitivity Pneumonia Triggered by Domestic Environmental Antigens: A Case Report. 过量使用含薄荷醇鼻吸入器致外源性脂质肺炎及国内环境抗原诱发急性超敏性肺炎1例
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5358-25
Yuki Fukushiro, Yasushi Horimasu, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Takeshi Masuda, Taku Nakashima, Hiroshi Iwamoto, Shinichiro Ohshimo, Kazunori Fujitaka, Noboru Hattori
{"title":"Exogenous Lipoid Pneumonia Induced by the Excessive Use of Menthol-containing Nasal Inhalers and Subsequent Acute Hypersensitivity Pneumonia Triggered by Domestic Environmental Antigens: A Case Report.","authors":"Yuki Fukushiro, Yasushi Horimasu, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Takeshi Masuda, Taku Nakashima, Hiroshi Iwamoto, Shinichiro Ohshimo, Kazunori Fujitaka, Noboru Hattori","doi":"10.2169/internalmedicine.5358-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5358-25","url":null,"abstract":"<p><p>A 58-year-old Japanese man presented at our hospital with respiratory failure. Computed tomography (CT) revealed scattered fat-attenuated consolidations, and bronchoalveolar lavage fluid (BALF) showed neutrophilia, leading to a diagnosis of exogenous lipoid pneumonia (ELP) caused by the excessive use of a menthol-containing nasal inhaler. Despite a temporary improvement, the patient experienced recurrent respiratory failure shortly after discharge. Computed tomography (CT) revealed centrilobular ground-glass opacities, and a bronchoalveolar BALF analysis revealed lymphocytosis, suggesting acute hypersensitivity pneumonitis (AHP) triggered by domestic environmental antigens. Antigen avoidance was successful and remission was maintained. The rare sequential occurrence of AHP following ELP suggests a potential pathophysiological connection between these conditions.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transbronchial Mediastinal Cryobiopsy in Diagnosing Sarcoidosis: A Three-Case Report. 经支气管纵隔冷冻活检诊断结节病3例报告。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5415-25
Chieri Yamada, Ryota Otoshi, Eri Hagiwara, Asami Moriuchi, Yoichi Tagami, Takashi Niwa, Tomohisa Baba, Tomoe Sawazumi, Tamiko Takemura, Takashi Ogura
{"title":"Transbronchial Mediastinal Cryobiopsy in Diagnosing Sarcoidosis: A Three-Case Report.","authors":"Chieri Yamada, Ryota Otoshi, Eri Hagiwara, Asami Moriuchi, Yoichi Tagami, Takashi Niwa, Tomohisa Baba, Tomoe Sawazumi, Tamiko Takemura, Takashi Ogura","doi":"10.2169/internalmedicine.5415-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5415-25","url":null,"abstract":"<p><p>Recent reports suggest that a transbronchial mediastinal cryobiopsy (TMC) offers a better diagnostic performance for benign diseases than endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) because it can obtain larger specimens. We herein report the utility of TMC in three patients with sarcoidosis at our institution. EBUS-TBNA failed to diagnose sarcoidosis in all three patients, whereas TMC provided a definitive diagnosis. Although no significant differences in either the safety or procedural complexity were observed between TMC and EBUS-TBNA, the cost of TMC remains a considerable challenge. Further research is required to determine the strategies regarding optimal patient selection for sarcoidosis patients who need a diagnosis of TMC.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two Cases of Mixed Neuroendocrine Non-neuroendcrine Cell Neoplasms (MiNENs) of the Pancreas with Notable Molecular Pathological Features. 胰腺混合性神经内分泌非神经内分泌细胞瘤2例，具有明显的分子病理特征。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5083-24
Satomi Saito, Yukiko Takayama, Mariko Tanaka, Nao Otsuka, Junichi Akao, Junko Tahara, Masataka Kikuyama, Katsutoshi Tokushige, Taito Itoh, Toru Furukawa, Ryota Higuchi, Takehisa Yazawa, Kyoko Shimizu
{"title":"Two Cases of Mixed Neuroendocrine Non-neuroendcrine Cell Neoplasms (MiNENs) of the Pancreas with Notable Molecular Pathological Features.","authors":"Satomi Saito, Yukiko Takayama, Mariko Tanaka, Nao Otsuka, Junichi Akao, Junko Tahara, Masataka Kikuyama, Katsutoshi Tokushige, Taito Itoh, Toru Furukawa, Ryota Higuchi, Takehisa Yazawa, Kyoko Shimizu","doi":"10.2169/internalmedicine.5083-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5083-24","url":null,"abstract":"<p><p>We herein report two cases of pancreatic mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs). Case A was a mixed ductal-neuroendocrine cell carcinoma with a KRAS mutation and loss of RB1 and SMAD4 expression. Case B was a mixed acinar-neuroendocrine cell carcinoma with wild-type KRAS and loss of p16 and SMAD4 expression. The expression of RB1 and ARID1A was also reduced. These results support the recently proposed classification of neuroendocrine carcinoma into ductal and acinar types based on molecular features, which may facilitate the understanding and development of specific treatments for this intractable tumor.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unusual Infiltration into the Common Bile Duct: A Rare Case of Diffuse Hepatic Metastases from Breast Cancer. 异常浸润至胆总管：一例罕见的乳腺癌弥漫性肝转移。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5646-25
Kento Ogawa, Yoshihide Matsumoto, Akiko Shimizu, Shigenobu Kuroki, Kozo Ikuta, Eri Senda, Seiji Shio
{"title":"Unusual Infiltration into the Common Bile Duct: A Rare Case of Diffuse Hepatic Metastases from Breast Cancer.","authors":"Kento Ogawa, Yoshihide Matsumoto, Akiko Shimizu, Shigenobu Kuroki, Kozo Ikuta, Eri Senda, Seiji Shio","doi":"10.2169/internalmedicine.5646-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5646-25","url":null,"abstract":"<p><p>A 39-year-old woman undergoing breast cancer treatment presented with a loss of appetite and fatigue. Computed tomography (CT) revealed diffuse heterogeneity in the left hepatic lobe and thickened bile duct walls with contrast enhancement. Diffusion-weighted magnetic resonance imaging (MRI) demonstrated a high signal intensity throughout the left hepatic lobe, extending to the common bile duct. The case findings highlight the extreme rarity of diffuse hepatic metastases with common bile duct infiltration in breast cancer and underscore the critical roles of CT and MRI in identifying distinctive imaging findings that are pivotal for making a diagnosis and selecting timely management.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Autopsy Case of a Desmoplastic Small Round Cell Tumor with a Rapid Fatal Outcome due to Diffuse Cystic Liver Metastases. 解剖一例结缔组织增生小圆细胞瘤，因弥漫性囊性肝转移而迅速死亡。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5050-24
Yosuke Saito, Tomomi Sanomachi, Shuhei Suzuki, Takanobu Kabasawa, Hidenori Sato, Hirofumi Watanabe, Fumiyoshi Fujishima, Hiroya Otake, Yuta Horie
{"title":"An Autopsy Case of a Desmoplastic Small Round Cell Tumor with a Rapid Fatal Outcome due to Diffuse Cystic Liver Metastases.","authors":"Yosuke Saito, Tomomi Sanomachi, Shuhei Suzuki, Takanobu Kabasawa, Hidenori Sato, Hirofumi Watanabe, Fumiyoshi Fujishima, Hiroya Otake, Yuta Horie","doi":"10.2169/internalmedicine.5050-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5050-24","url":null,"abstract":"<p><p>Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive malignancy with a poor prognosis. We report an autopsy case of DSRCT in a 24-year-old male with a rapidly fatal outcome due to unusual diffuse cystic liver metastases. Despite an initial complete response to therapy, the patient developed extensive hepatic involvement leading to acute liver failure. Autopsy revealed widespread DSRCT with cystic degeneration in the liver metastases, which was confirmed by EWSR1 rearrangement. This case highlights the unpredictable nature of DSRCT and its potential for an atypical presentation, while emphasizing the need for improved therapeutic strategies.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Following Development of Central Diabetes Insipidus: A Case Report and Literature Review. 中枢性尿囊症并发嗜酸性肉芽肿合并多血管炎1例报告并文献复习。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5558-25
Tatsuaki Kosaka, Shinya Yamamoto, Naoko Yasugi, Sayaka Sugioka, Takuro Hakata, Rintaro Saito, Ryosuke Hiwa, Sho Koyasu, Yuki Teramoto, Motoko Yanagita
{"title":"A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Following Development of Central Diabetes Insipidus: A Case Report and Literature Review.","authors":"Tatsuaki Kosaka, Shinya Yamamoto, Naoko Yasugi, Sayaka Sugioka, Takuro Hakata, Rintaro Saito, Ryosuke Hiwa, Sho Koyasu, Yuki Teramoto, Motoko Yanagita","doi":"10.2169/internalmedicine.5558-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5558-25","url":null,"abstract":"<p><p>Central diabetes insipidus (CDI) can develop as an acquired systemic disease. However, cases of eosinophilic granulomatosis with polyangiitis (EGPA) with concurrent CDI are rare. We herein report a case of EGPA following CDI. A 68-year-old woman with a 30-year history of sinusitis and asthma developed CDI, followed by severe renal dysfunction with eosinophilia and elevated MPO-ANCA levels. A renal biopsy confirmed EGPA. Intensive treatment resulted in dialysis discontinuation, while partial improvement in AVP secretion suggested a potential link between EGPA and CDI. We also conducted a literature review on concurrent EGPA and CDI. Clinicians should be aware of EGPA in CDI patients with asthma or sinusitis.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Advanced Lung Cancer in Pregnancy: Multidisciplinary Treatment and Early Delivery; A Case Report. 晚期妊娠期肺癌的管理：多学科治疗和早期分娩一个病例报告。
Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI: 10.2169/internalmedicine.5355-25
Hiroaki Nagamine, Hiroyasu Kaneda, Syotaro Yamamoto, Kohei Kitada, Yoko Tani, Takako Oka, Yoshiya Matsumoto, Toshiyuki Nakai, Kazuhiro Yamada, Tetsuya Watanabe, Kazuhisa Asai, Yoshitaka Nakao, Daisuke Tachibana, Tomoya Kawaguchi
{"title":"Management of Advanced Lung Cancer in Pregnancy: Multidisciplinary Treatment and Early Delivery; A Case Report.","authors":"Hiroaki Nagamine, Hiroyasu Kaneda, Syotaro Yamamoto, Kohei Kitada, Yoko Tani, Takako Oka, Yoshiya Matsumoto, Toshiyuki Nakai, Kazuhiro Yamada, Tetsuya Watanabe, Kazuhisa Asai, Yoshitaka Nakao, Daisuke Tachibana, Tomoya Kawaguchi","doi":"10.2169/internalmedicine.5355-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5355-25","url":null,"abstract":"<p><p>The poor prognosis of lung cancer during pregnancy requires complicated management. A 40-year-old woman at 25 weeks' gestation was admitted with persistent back pain. Imaging findings suggested lung cancer. A multidisciplinary team determined that early intervention was crucial, and Caesarean delivery was performed at 27 weeks' gestation. Thereafter, the patient was diagnosed with lung adenocarcinoma with bone metastasis. The patient underwent rapid opioid titration and radiation therapy for the bone metastases. We then introduced chemotherapy and offered an advanced care plan. A multidisciplinary approach is essential for pregnant women with lung cancer. Early delivery is recommended to expedite the diagnosis and treatment.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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