Long-term survival by surgery and adjuvant chemotherapy in a patient with perforated extranodal NK/T-cell lymphoma of the small intestine: a retrospective case study.

Adjuvant chemotherapy Extranodal NK/T-cell lymphoma Long-term survival Nasal type Perforation Small intestine

Journal

Surgical case reports
ISSN: 2198-7793
Titre abrégé: Surg Case Rep
Pays: Germany
ID NLM: 101662125

Informations de publication

Date de publication:
12 Jun 2023
Historique:
received: 26 02 2023
accepted: 06 06 2023
medline: 12 6 2023
pubmed: 12 6 2023
entrez: 12 6 2023
Statut: epublish

Résumé

Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) of the small intestine, is a disease with extremely poor prognosis. We describe treatment in a case which is novel in that it demonstrated long-term survival. A 68-year-old man was admitted to the emergency department of our hospital with the complaint of severe umbilical pain with tenderness and muscular defense. An abdominal computed tomography scan revealed a thick-wall mass on the small intestine and intra-abdominal free air. He was suspected of perforation of a small intestinal tumor and underwent emergency surgery. The surgery revealed a perforated tumor ulcer, and ENKL was diagnosed from the postoperative pathological findings. The patient's postoperative course was uneventful. He was further treated with adjuvant chemotherapy by hematologist comprising six courses of dexamethasone, etoposide, ifosfamide, and carboplatin. The patient demonstrated long-term survival and was in remission at the time of writing, four years and five months after surgery. We report a rare case of long-term survival of perforated ENKL of the small intestine achieved by surgery and adjuvant chemotherapy with dexamethasone, etoposide, ifosfamide, and carboplatin. It is essential to consult with a hematologist to determine the most appropriate chemotherapy such as DeVIC if one encounters rare postoperative pathological findings of ENKL. To elucidate the pathophysiology of this disease and to prolong survival of affected patients, accumulation of cases of long-term survival and examination of associated characteristics is necessary.

Sections du résumé

BACKGROUND BACKGROUND
Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) of the small intestine, is a disease with extremely poor prognosis. We describe treatment in a case which is novel in that it demonstrated long-term survival.
CASE PRESENTATION METHODS
A 68-year-old man was admitted to the emergency department of our hospital with the complaint of severe umbilical pain with tenderness and muscular defense. An abdominal computed tomography scan revealed a thick-wall mass on the small intestine and intra-abdominal free air. He was suspected of perforation of a small intestinal tumor and underwent emergency surgery. The surgery revealed a perforated tumor ulcer, and ENKL was diagnosed from the postoperative pathological findings. The patient's postoperative course was uneventful. He was further treated with adjuvant chemotherapy by hematologist comprising six courses of dexamethasone, etoposide, ifosfamide, and carboplatin. The patient demonstrated long-term survival and was in remission at the time of writing, four years and five months after surgery.
CONCLUSIONS CONCLUSIONS
We report a rare case of long-term survival of perforated ENKL of the small intestine achieved by surgery and adjuvant chemotherapy with dexamethasone, etoposide, ifosfamide, and carboplatin. It is essential to consult with a hematologist to determine the most appropriate chemotherapy such as DeVIC if one encounters rare postoperative pathological findings of ENKL. To elucidate the pathophysiology of this disease and to prolong survival of affected patients, accumulation of cases of long-term survival and examination of associated characteristics is necessary.

Identifiants

pubmed: 37306807
doi: 10.1186/s40792-023-01688-7
pii: 10.1186/s40792-023-01688-7
pmc: PMC10260716
doi:

Types de publication

Journal Article

Langues

eng

Pagination

103

Informations de copyright

© 2023. The Author(s).

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Auteurs

Hiroshi Funaki (H)

Department of Surgery, Ushitsu General Hospital, 97 Ta-Aza, Ushitsu, Housu-Gun, Noto-Cho, Ishikawa, 927-0495, Japan. hrsfunaki@gmail.com.

Naomi Nojima (N)

Department of Surgery, Ushitsu General Hospital, 97 Ta-Aza, Ushitsu, Housu-Gun, Noto-Cho, Ishikawa, 927-0495, Japan.

Yutaka Takikawa (Y)

Department of Surgery, Ushitsu General Hospital, 97 Ta-Aza, Ushitsu, Housu-Gun, Noto-Cho, Ishikawa, 927-0495, Japan.

Kazutoshi Komori (K)

Department of Surgery, Ushitsu General Hospital, 97 Ta-Aza, Ushitsu, Housu-Gun, Noto-Cho, Ishikawa, 927-0495, Japan.

Hajime Hasegawa (H)

Department of Surgery, Ushitsu General Hospital, 97 Ta-Aza, Ushitsu, Housu-Gun, Noto-Cho, Ishikawa, 927-0495, Japan.

Tomoyuki Sakai (T)

Department of Hematology and Immunology, Kanazawa Medical University, Kahoku, Ishikawa, Japan.

Sohsuke Yamada (S)

Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan.

Yasufumi Masaki (Y)

Department of Hematology and Immunology, Kanazawa Medical University, Kahoku, Ishikawa, Japan.

Classifications MeSH