🦎 蜥蜴花園

Search

SearchSearch

LUNGNETS

Dec 05, 20232 min read

Info

🌱來自: snippets

LUNGNETS

Lung NETs, G2 (Ki-67:~25%, lung biopsy), dx on 2019/9/5, cT4N1Mx, stage IIIA or IVA if M1b (right adnexa mets) with clinically significant tumor burder and evidence of progression (hoarsness) intermediat grade (atypical)

*2017 WHO classification of lung NETs: W/D: Low grade (G1): <2 mitoses/10 HPF and no necrosis; intermediate grade (G2): 2-10 mitoses/10 HPF and/or foci of necrosisp; high grade (G3); P/D: >10 mitoses/10 HPF

  • Initial presentation:
  • 2010/0/10 check for functioning tumor or not: ask s/s such as whezzing, cutaneous flushing, and diarrhea, or bronchoconstrition, cardiac valvular fibrosis
  • 2010/0/10 survey for MEN-1 (pituitary tumor and/or hyperparathyroidism) and cushing syndrome: brain MRI (2019/9/9) negative
  • Offer referral to NTUH 核醫科鄭湄芳 (0972653453) for gallium 68 scan clinical trial available since July, 2019 if necessary
  • 2010/0/10 Send pathology for IHC stain (SSRI 2a), contact pathology
  • 2010/0/10 Explain treatment startegy: observe or somatostatin analogue (wait SSTR-2a data), everolimus if NHI reimbursed, PRRT if positive GA68 scan, E+P, or temozolomide +- xeloda @ Explain pathology final result and treatment strategy @ need to check CGA and urine 5-HIAA @ Catastrophic card @ Vascular assessment, rehabilitation, nutritional assessment (high protein diet), dental check (left mandible uptake by PET-CT) and pharmacist education before treatment @ Refer to endocrinologist for survey of cushing’s disease (hypertension since 2018 and mild obesity and lung carcinoid tumor) @ Refer to GYN for right adnexa lesion

Siblings

Graph View

Backlinks