74 year old female.
Diverticular disease of the colon
Radical hysteroannessiectomy performed 27 years ago.
Patient recently (November 2007) underwent PTCA and Stent on left anterior descending coronary artery and circumflex artery for three-vessel coronary disease with proximal occlusion of the descending coronary artery.
On January 2008, the patient was admitted to the hospital in her city for thickening of the left lung, already typified by means of fine-needle aspiration, as non-small cell lung cancer (NSCLC). The patient was already in possession of the following documentation:
Chest CAT scan: nodule with spiculated margins of possible hyperplastic nature in the lingular sub-segment. Millimetric parenchymal nodules suspected as secondary in the ventral segment of the upper right lobe, in the segments of the basal pyramid of the upper right lobe and lower left lobe.
PET SCAN: pathological accumulation of the radioactive marked glucose analogue at the level of the lingula.
Fibre bronchoscopy: no pathological findings within visibility limits of endoscopy.
Brain CAT scan: no secondary lesions.
CT guided lung needle biopsy: non-small cell lung cancer (NSCLC).
Whilst in hospital, routine diagnostic tests and examinations were carried out (blood chemistry tests, chest radiogram in 2 projections, respiratory function tests) to complete the documentation provided by the patient: given the fact that the clinical condition is marked by being positive for lung neoplasia to the lingular segment, after careful cardiological and pneumological evaluation, a surgical approach was decided on.
As such, on January, 2008, the patient underwent a lingular segmental resection of the left lung.
Immediate post-operative progress was normal in intensive care, where the patient was kept for approximately 24 hours as a cautionary measure, given her cardiological history.
The final histological report showed a well-differentiated mixed acinar and bronchoalveolar adenocarcinoma (T1 N0).
She was discharged on February 2008 and returned for a check-up with the chest surgical ward on February 2008. At this time, the following was reported upon objective examination:
“Patient currently eupnoeic, presence of vesicular murmur diffused bilaterally. She complains of persistent pain to the chest starting from the wound radiating anterior to the chest. Recommended treatment with the following painkillers: Contramal 20 drops twice a day, and Lixidol 1 tablet a day”. An oncological evaluation of the surgical results was also requested, which was carried out on March 2008, reporting as follows:
Diagnosis: lung neoplasia Histotype: Adenocarcinoma
T 1 N 0 M 0
Stage IA grading 1
No instruction to carry out any specific oncological therapy.
The patient currently keeps to the following home treatment:
Blopresid 1 tablet
Cardura 2 mg 1 tablet
Cardioaspirin 100 mg 1 tablet
Losec 20 mg 1 tablet
Zyloric 300 mg 1 tablet.