VENA KAVA SÜPERİOR SENDROMUYLA TANI ALAN YÜKSEK DERECELİ NÖROENDOKRİN KARSİNOM: OLGU SUNUMU

Yıl 2020, , 243 - 246, 30.06.2020

Nagihan Kolkıran , Gamze Göksel , Ferhat Ekinci Atike Pınar Erdoğan , Ahmet Dirican , Cihan Göktan

https://doi.org/10.34087/cbusbed.575496

Öz

   Nöroendokrin
tümörler başta akciğer ve gastrointestinal sistem olmak üzere tüm vücutta
görülebilen nadir tümörlerdir.(1,2) 
Akciğer karsinomlarının %20 ‘sini oluşturur.(1,2) Akciğer nöroendokrin
tümörlerde vena kava süperior sendromu (VKSS) sıklığı bilinmemektedir. İntratorasik
maligniteler VKSS’nin %60-%85’inden sorumludur ve tümör tanısı önceden konulmamış
bu olguların %60 ‘ı vena kava superior obstrüksiyonu ile prezente olur. Bu
olgularda venöz obstrüksiyon; vena kava süperiora primer tümörün, mediastinal
lenf nodlarının dıştan basısı veya  direk
tümör invazyonu sonucunda meydana gelir. Literatürde sağkalım verileri olgu
sunumu düzeyinde olmakla birlikte tedavisiz kalan olgularda sağkalım 1 ay
civarında bildirilmektedir. Bu nedenle hızlı tanı konulup uygun tedavinin
planlanması hayati önem taşımaktadır. Burada akciğer nöroendokrin tümör
nedeniyle VKSS gelişen olgunun tanısal süreci ve prognozu sunulmuştur.

Anahtar Kelimeler

Vena kava superior sendromu, nöroendokrin tümör, tedavi

Kaynakça

• 1. Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid” : epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008; 26:3063-3072.2. Volante M, Gatti G, Papotti M. Classification of lung neuroendocrine tumors: lights and shadows. Endocrine. 2015; 50(2): 315-319.3. Hendifar AE, Marchevsky AM, Tuli R. Neuroendocrine Tumors of the Lung: Current Challenges and Advances in the Diagnosis and Management of Well- Differenriated Disease. Journal of Thoracic Oncology 2016; 3: 425-436. 4. Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore). 2006;85(1):37.5. Yellin A, Rosen A, Reichert N, Lieberman Y. Superior vena cava syndrome. The myth--the facts. Am Rev Respir Dis. 1990;141(5 Pt 1):1114. 6. Schraufnagel DE, Hill R, Leech JA, Pare JA. Superior vena caval obstruction. Is it a medical emergency? Am J Med. 1981;70(6):1169.7. Friedman T, Quencer KB, Kishoer SA, Winokur RS, Madoff DC. Malignant Venous Obstruction: Superior Vena Cava Syndrome and Beyond. Semin Intervent Radiol. 2017;34(4):398.8. Kalra M, Sen I, Gloviczki P. Endovenous and Operative Treatment of Superior Vena Cava Syndrome. Surg Clin North Am. 2018;98(2):321.9. García Mónaco R, Bertoni H, Pallota G, Lastiri R, Varela M, Beveraggi EM, Vassallo BC. Use of self-expanding vascular endoprostheses in superior vena cava syndrome. Eur J Cardiothorac Surg. 2003;24(2):208. 10. Yu JB, Wilson LD, Detterbeck FC (2008) Superior Vena Cava Syndrome: a proposed classification system and algorithm for management. J Thorac Oncol 3(811–814):8.Wan JF, Bezjak A. Superior vena cava syndrome. Hematol Oncol Clin N Am 2010;24:501-13.11. Mesko SM, Rosenthal KJ, Boasberg PD, Omid H. BRAF-Targeted Therapy to Treat Superior Vena Cava Syndrome in Patient with Metastatic Cancer. J Clin. Oncol. 2015;33:101-103. 12. Wan JF, Bezjak A. Superior vena cava syndrome. Hematol Oncol Clin N Am 2010;24:501-13.13. Rowell NP, Gleeson FV. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus. Cochrane Database Syst Rev 2001;CD001316.14. Armstrong BA, Perez CA, Simpson JR, Hederman MA (1987) Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys 13:531–539.15. Yellin A, Rosen A, Reichert N, Lieberman Y (1990) Superior vena cava syndrome. The myth–the facts. Am Rev Respir Dis 141:1114–1118. doi:10.1164/ajrccm/141.5_Pt_1.1114.16. Nicholson AA, Ettles DF, Arnold A, Greenstone M, Dyet JF (1997) Treatment of malignant superior vena cava obstruction: metal stents or radiation therapy. J Vasc Interv Radiol 8:781–788.17. Mose S, Stabik C, Eberlein K, Ramm U, Bottcher HD, Budischewski K (2006) Retrospective analysis of the superior vena cava syndrome in irradiated cancer patients. Anticancer Res 26:4933–4936.18. Ostler PJ, Clarke DP, Watkinson AF, Gaze MN (1997) Superior vena cava obstruction: a modern management strategy. Clin oncol (R Coll Radiol) 9:83–89 Parish JM, Marschke RF Jr, Dines DE, Lee RE (1981) Etiologic considerations in superior vena cava syndrome. Mayo Clin Proc 56:407–413.19. Davenport D, Ferree C, Blake D, Raben M (1978) Radiation therapy in the treat ment of superior vena caval obstruction. Cancer 42:2600–2603 de Jager CP, Rutten MJ, Lips DJ (2013) “Benign” superior vena cava syndrome. Intensive Care Med 39:572–573.20. Straka C, Ying J, Kong FM et al. Review of evolving etiologies, implications and treatment strategies for the superior vena cava syndrome. SpringerPlus (2016) 5:229.21. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer. Version 1.2016.22. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology:Neuroendocrine and Adrenal Tumors, Version 2.2018.23. Martins SJ, Pereira JR. Clinical factors and survival in non-small cell lung cancer. Am J Clin Oncol 1999; 22:453-7