Authors
Korzhuk M.S.1, 2, Surov D.A.1, 3, Novikova M.V.1, Demko A.E.3, Khomutova E.Y.2, Eselevich R.V.1, Andabekov T.T.4, Balyura O.V.1, Dymnikov D.A.1, Rezina A.I.4
1 S.M. Kirov Military medical academy, St. Petersburg
2 Omsk State Medical University, Omsk
3 Research Institute Of Emergency Medecine named after I.I. Djanelidzе, St. Petersburg
4 LLC «AV MedikalGroup», St. Petersburg
5 NWSMU named after I. I. Mechnikov, St. Petersburg
Abstract
A clinical observation of a patient with stage IIIB of non-small cell carcinoma of the left lung (NSCLC) is presented. The diagnosis was established in 2018.
In 2018–2020, the patient received complex treatment, which included immunotherapy with pembrolizumab, surgical treatment in the amount of extended lower lobectomy with lymphadenectomy, and stereotaxic radiation therapy. Process stabilization has been achieved.
In 2021, despite the ongoing complex treatment, progression of high-grade (PD-1L positive reaction in 90% of tumor cells) NSCLC was revealed — metastases to the jejunum and its mesentery. In July 2021, surgical treatment was performed for gastrointestinal metastases complicated by necrosis and bleeding. The indications, surgical technique and its results are discussed in detail.
Keywords: non-small cell lung cancer, complex treatment, distant metastasis, gastrointestinal metastasis, immunotherapy, PD-L1, surgery for metastases.
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