So worenya mmati mu yaw na wo nsa ayɛ mmerɛw? Ebetumi ayɛ Pancoast Tumor!

So wunya mmati mu yaw a wontumi nkyerɛkyerɛ mu, ɛtɔ mmere bi a ɛwɔ wo kɔn nkyɛn, ne ɛyaw a ɛba wo nsa ase, na wo nsa mu yɛ wo yaw? Ɛtɔ da bi a, ebia yebesusuw sɛ ɛyɛ ntini a ɛyɛ mmerɛw anaa ntini a ɛyɛ mmerɛw ara kwa. Nanso, ɛtɔ mmere bi a saa sɛnkyerɛnne ahorow yi betumi ayɛ biribi a anibere wom kɛse ho sɛnkyerɛnne. Ɛno ne tebea a yɛbɛka ho asɛm nnɛ, a wɔfrɛ no Pancoast Tumor.

Dɛn ne Pancoast Tumor? Sɛ yɛbɛka no tiawa a...

Susuw ho hwɛ, Pancoast tumor yɛ ahurututu mu kokoram bi . Nanso ɛyɛ nwonwa kakra. Ɛyɛ w’ahurututu no atifi pɛɛ, wɔ wo mpampam a edi kan no atifi pɛɛ. Nea ɛnte sɛ ahurututu mu kokoram afoforo no, Pancoast akisikuru mma obi mfa ɔfe anaa ne koko mu yaw . Mmom no, nnipa a wɔwɔ saa akisikuru yi taa te wɔn mmati mu yaw kɛse na wɔn nsa yɛ mmerɛw . Nnuruyɛfo frɛ saa sɛnkyerɛnne ahorow a wɔaka abom yi "Pancoast syndrome." Pancoast syndrome mma ahurututu mu kokoram a ɛtaa ba no ho sɛnkyerɛnne mma, enti ebetumi agye bere kakra ansa na wɔahu saa akisikuru yi. Mpɛn pii no, wonhu yare no yiye kosi sɛ kokoram no bɛtrɛw akɔ ntini ne mogya ntini a ɛbɛn hɔ no mu. Wɔde radiologist a odii kan kaa ho asɛm wɔ afeha a ɛto so 20 mfiase no din ato pancoast tumors. Edin foforo a wɔde frɛ wɔn ne superior sulcus tumor.

So eyi ahorow bi wɔ hɔ?

Yiw, Pancoast akisikuru ahorow nketenkete pii wɔ hɔ. Wɔn titiriw ne:

• Ahurututu mu kokoram a ɛnyɛ nkwammoaa nketewa - sɛ nhwɛso no, adenocarcinomas ne squamous cell carcinomas.
• Nkwammoaa nketewa ahurututu mu kokoram .

Pancoast akisikuru dodow no ara yɛ kokoram bi a wɔfrɛ no adenocarcinomas . Saa kokoram ahorow yi fi ase wɔ wo mframa kwan ne ntini nketenkete a ɛwɔ w’ahurututu mu (mframa kotoku nketenkete a ɛwɔ w’ahurututu mu) no mu, titiriw wɔ ntini mu nkwammoaa a ɛyɛ nsu a ɛyɛ nwini no mu.

Saa tebea yi abu so dɛn?

Pancoast tumors are very rare , a ennu ahurututu mu akisikuru nyinaa mu 5%.

Dɛn ne eyi ho sɛnkyerɛnne? Momma yɛnhwɛ mu yiye!

Pancoast tumor bi na ɛka wo brachial plexus no.Wobetumi ahyɛ saa ntini ahorow yi mu den. Saa ntini yi fi wo moma so atifi fa wo kɔn mu kɔ wo nsa so. Sɛ wɔde saa nhyɛso yi di dwuma a, sɛnkyerɛnne pɔtee bi betumi aba. Ɛno nti na nnuruyɛfo frɛ no Pancoast syndrome anaa Pancoast-Tobias syndrome no. Saa sɛnkyerɛnne ahorow yi ba ɔfã koro no ara a akisikuru no ba . Sɛ nhwɛso no, sɛ akisikuru no wɔ w’ahurututu nifa mu a, sɛnkyerɛnne no bɛka wo nipadua nifa nso. Pancoast tumor ho sɛnkyerɛnne betumi ayɛ:

• Mmati mu yaw a emu yɛ den : Ebia nea ɛka eyi ho ne ɛyaw a ɛba wo mmati mu.
• Ɛyaw a ɛhyerɛn kɔ abasa no ase: Ebia ɛyaw yi begyae wɔ nsateaa no atifi, wɔ nsateaa ketewa no atifi pɛɛ.
• Nsa ne abasa mu mmerɛwyɛ.
• Kɔn mu yaw.
• Ɛyaw a ɛba mpampam no atifi.
• Abasa a ɛwɔ soro a ɛho ahonhon.
• Nsa ne nsateaa mu ahokokwaw a wɔhwere .
• Nsa a ɛyɛ mmerɛw anaasɛ ɛyɛ mmerɛw.
• Ɔbrɛ.
• Koko a ɛyɛ den.
• Mu duru a ɛso tew a ntease biara nnim.

Nnipa a wɔwɔ Pancoast tumors no mu bɛyɛ 50% nso nya tebea bi a wɔfrɛ no Horner’s syndrome , a ebetumi de sɛnkyerɛnne ahorow te sɛ:

• Anim a wɔhohoro .
• Aniwa a ɛrehwe ase (ptosis).
• Aniwa a ɛdannan kɔ mu (enophthalmos).
• Fifiri a wonnya (anhidrosis).

Dɛn na ɛde eyi ba? Dɛn ne nneɛma a ɛde asiane ba?

Nea ɛde Pancoast akisikuru ba ne nea ɛde asiane ba no te sɛ ahurututu mu kokoram afoforo. Nneɛma atitiriw a ɛde asiane ba ne:

• Sigaretnom .
• Wusiw a wɔde di dwuma a wɔde di dwuma.
• Nneɛma bi te sɛ asbestos, radon gas, ne dade a emu yɛ duru a wɔde wɔn ho bɛhyɛ mu bere tenten.

Susuw ho hwɛ, sɛ yɛde yɛn ho hyɛ saa nneɛma yi mu a, na yɛresɛe yɛn ahurututu a yennim. Enti ɛho hia paa sɛ yɛhwɛ yiye wɔ eyi ho.

Ɔkwan bɛn so na eyi trɛw?

Kokoram trɛw bere a kokoram nkwammoaa no tetew fi mfitiase akisikuru no ho, fa wo mogya nhyehyɛe anaa wo mogya mu ntini nhyehyɛe mu, na wɔyɛ akisikuru foforo wɔ wo nipadua no afã afoforo no. Mpɛn pii no, pancoast tumors tumi trɛw fi ahurututu no atifi kɔ mmeae a edidi so yi:

• Koko a ɛwɔ soro.
• Wɔabɔ wɔn tirim.
• Thoracic ribs a ɛwɔ akyi berɛmo mu.
• Mogya ntini a ɛbɛn nsa no paa.

Wɔfrɛ kokoram a ɛtrɛw kɔ mmeae a ɛwɔ akyirikyiri yi sɛ metastasis .

Ɔkwan bɛn so na wohu eyi?

Wɔ mfiase no, ɛnyɛ mmerɛw sɛ wobehu Pancoast akisikuru wɔ koko mu X-ray a wɔde afã abien a wɔtaa de di dwuma no so. Ɛno nti na ebetumi ayɛ den sɛ wobehu wɔn. Sɛ oduruyɛfo bi gyina wo sɛnkyerɛnne ahorow so susuw sɛ Pancoast akisikuru bi wɔ hɔ a, ebia ɔbɛkamfo akyerɛ sɛ wɔnyɛ nhwehwɛmu afoforo a ɛbɛma wɔahu, te sɛ:

• Mfoninitwa sɔhwɛ afoforo.
• Needle biopsy a wɔde yɛ nipadua no.
• Oprehyɛn a wɔde video boa a wɔde hwɛ ahurututu mu (VATS).
• Thoracotomy oprehyɛn a wɔyɛ.

Mfoninitwa sɔhwɛ ahorow

Mfiridwuma a ɛkɔ akyiri a wɔde twa mfonini betumi aboa wo duruyɛfo ma wahu w’ahurututu ho mfonini pefee. Obetumi ahyɛ sɛ wɔnyɛ sɔhwɛ ahorow te sɛ eyinom:

• CT scan (CT - kɔmputa so mfoninitwa afiri).
• PET scan (positron emission tomography mfonini a wɔde hwehwɛ nneɛma mu).
• MRI scan (MRI - magnetic resonance mfonini a wɔde yɛ nneɛma).

Saa scan ahorow yi betumi ama yɛanya nsɛm pii, te sɛ akisikuru no kɛse, beae a ɛwɔ, ne sɛ ebia atrɛw akɔ mmeae afoforo anaa.

Needle biopsy a wɔde yɛ nipadua no

Wɔ needle biopsy mu no, oduruyɛfo bi fa nsu, ntini, anaa nkwammoaa bi fi akuru bi a ɛnyɛ ne kwan so mu. Afei wɔde nhwɛsode no kɔ pathology lab kɔyɛ nhwehwɛmu foforo. Ɛhɔ nkutoo na yebetumi ahu no yiye sɛ ebia ɛyɛ kokoram ne kokoram ko.

VATS (oprehyɛn a wɔde video boa a wɔde hwɛ ahurututu mu) .

Wɔ saa adeyɛ yi mu no, oduruyɛfo bi twa wo moma so ketewaa bi na ɔde thoracoscope (afiri a ɛyɛ tratraa a mfoninitwa afiri ketewaa bi wɔ so) hyɛ mu. Eyi ma otumi hwɛ wo koko mu na ɔhwɛ sɛ ebia akisikuru anaa nneɛma afoforo a ɛnteɛ anaa. Sɛ wohu bi a, wɔfa ntini bi na wɔde kɔ aduruyɛdan mu kɔhwɛ.

Thoracotomy a wɔde yɛ adwuma

Wɔ tebea horow bi mu no, ebia ebehia sɛ oduruyɛfo yɛ ahurututu. Wɔ eyi mu no, wɔtwa wo moma so nifa anaa benkum, wɔ mparow no ntam. Eyi ma wotumi hu ahurututu a ɛka wɔn no yiye na wɔyɛ ntini biara a ɛnteɛ mu nhwehwɛmu. Mpɛn pii no, wobeyi akisikuru no nso bere koro no ara mu. Eyi bɛma woanya oprehyɛn pii.

Momma yensua sɛnea kokoram yi di dwuma wɔ gyinabea no ho ade.

Te sɛ ahurututu mu kokoram ahorow afoforo no, nnuruyɛfo de nhyehyɛe bi a wɔde kyerɛ kokoram no kyekyɛ Pancoast akisikuru mu . Wɔde Roma akontaahyɛde (I, II, III, IV) ne subtypes (A, B) di dwuma de kyerɛkyerɛ sɛnea akisikuru no akɔ anim ne baabi a atrɛw akodu no mu. Wɔ Pancoast akisikuru ho no, nnuruyɛfo de nkyerɛwde T, N, M ne nɔma 1, 2, 3, 4 di dwuma de kyerɛ sɛnea tebea no mu yɛ den:

• Nkyerɛwde T kyerɛ sɛnea wo akisikuru no kɛse te ne baabi a atrɛw akodu.
• Nkyerɛwde N kyerɛ sɛ ebia kokoram no atrɛw akɔ wo ntini a ɛma mogya tu mu anaa .
• Nkyerɛwde M kyerɛ sɛ ebia kokoram no atrɛw akɔ nipadua no afã horow a ɛwɔ akyirikyiri (metastasis) .

Mpɛn bɛn na wɔtaa hu Pancoast akisikuru?

Esiane sɛ ɛyɛ den sɛ wobehu Pancoast tumors wɔ mfiase nti, wohu dodow no ara wɔ stage T3 anaa T4 mu. T3 kyerɛ sɛ kokoram no atrɛw akɔ wo moma so fasu anaa wo tema ntini ahorow mu. T4 kyerɛ sɛ kokoram no atrɛw akɔ nneɛma afoforo te sɛ wo nsateaa mu ntini anaa w’akyi berɛmo mu. Eyi yɛ tebea a emu yɛ den kɛse.

Dɛn ne ayaresa no?

Eyi gyina baabi a akisikuru no wɔ ne baabi a kokoram no atrɛw akodu so. Ayaresa ahorow pii wɔ hɔ a wobetumi apaw:

• Chemoradiation ne oprehyɛn a wɔyɛ.
• Chemoimmunotherapy ne oprehyɛn a wɔyɛ.
• Chemoradiation ne immunotherapy a wɔde sa yare.
• Mframa a wɔde sa yare.
• Ayaresa a wɔde wɔn ani asi so.

Chemoradiation ne oprehyɛn a wɔyɛ

Oprehyɛn ne ayaresa a eye sen biara bere biara a ɛbɛyɛ yiye. Nanso, ansa na wɔbɛyɛ oprehyɛn no, nnuruyɛfo betumi ama wo chemoradiation — chemotherapy ne radiation therapy a wɔaka abom — na ama akisikuru no so atew. Oprehyɛn a wɔyɛ de yi Pancoast akisikuru bi no betumi ayɛ den kakra. Mpɛn pii no, ɛsɛ sɛ oduruyɛfo a ɔyɛ oprehyɛn yi wo mpampam abien a ɛwɔ soro no. Ebia ɛsɛ sɛ woyi ntini kɛse bi nso na wɔde ntini a wɔde hyɛ nipadua mu — afiri a wɔde ayɛ a ɛma mogya tu si ananmu. Wo duruyɛfo a ɔyɛ wo oprehyɛn no bɛkyerɛkyerɛ eyinom nyinaa mu akyerɛ wo ansa na wɔayɛ wo oprehyɛn no.

Chemoimmunotherapy ne oprehyɛn a wɔyɛ

Wɔ tebea horow bi mu no, nnuruyɛfo betumi akamfo oprehyɛn ne chemoimmunotherapy akyerɛ.– kyerɛ sɛ, wɔde nnuru a wɔde sa yare ne nnuru a ɛko tia nyarewa a wɔaka abom – di dwuma. Bere a nnuru a wɔde sa kokoram kunkum kokoram nkwammoaa na ɛma akisikuru no nyin brɛoo no, nipadua no mu tumi a ɛko tia nyarewa no kanyan w’ankasa nipadua mu ahoɔden a ɛko tia nyarewa no ma ɛboa ma wɔko tia kokoram no.

Chemoradiation ne immunotherapy a wɔde sa yare

Ɛtɔ mmere bi a, oprehyɛn nyɛ ade a wobetumi apaw. Wɔ tebea horow a ɛtete saa mu no, ebia w’aduruyɛfo kuw no bɛkamfo nnuru a wɔde di dwuma wɔ nipadua mu ne nnuru a ɛko tia nyarewa a wɔde bɛka abom akyerɛ.

Mframa a wɔde sa yare

Sɛ oprehyɛn ntumi nyɛ yiye na kokoram no atrɛw akɔ nipadua no afã afoforo a, ebia wo duruyɛfo no bɛkamfo mframa a wɔde sa yare nkutoo akyerɛ na ama kokoram no nyin. Saa ɔhwɛ a ɛboa yi betumi atew kokoram no so na ama wo sɛnkyerɛnne ahorow no afi hɔ.

Ayaresa a wɔde wɔn ani asi so

Nnipa binom nya ayaresa a wɔde wɔn ani asi so so mfaso . Saa ayaresa yi de n’ani si awosu mu nsakrae a ɛma nkwammoaa a ɛte apɔw dan kokoram nkwammoaa so. Nea ɛbɛyɛ na oduruyɛfo bi ahu sɛ ebia woyɛ obi a ɔfata sɛ wɔde ayaresa a wɔde wɔn ani asi so bedi dwuma no, ɔbɛsɔ wo kokoram nkwammoaa ahwɛ sɛ ebia wɔwɔ protein pɔtee bi a ɛma wogye protein pɔtee bi anaa. Sɛ wowɔ nsɛmmisa bi fa eyi ho a, wo ne wo duruyɛfo nkasa.

So wobetumi asiw eyi ano?

Ɛwom sɛ wontumi nsiw Pancoast akisikuru ano koraa de, nanso nneɛma bi wɔ hɔ a wubetumi ayɛ de atew asiane a ɛwɔ hɔ sɛ wubenya kokoram yi so:

• Kwati sigaretnom ne tawa nneɛma afoforo. Sɛ wonom sigaret a, wo ne wo duruyɛfo nkasa na ɔmmoa wo ma wogyae.
• Kwati sɛ wode wo ho bɛhyɛ wusiw a wɔde di dwuma mu sɛnea wubetumi biara.
• Hwɛ hu sɛ nnuru a epira te sɛ asbestos nni nneɛma a atwa wo ho ahyia no mu .

Ɛwom sɛ eyinom betumi ayɛ te sɛ nneɛma nketenkete de, nanso ebetumi anya w’akwahosan so nkɛntɛnso kɛse bere tenten.

Bio nso, sɛ obi a ɔwɔ w’abusua mu anya ahurututu mu kokoram, anaasɛ asiane kɛse wɔ hɔ sɛ wubenya ahurututu mu kokoram a, ɛbɛyɛ papa sɛ wubebisa wo duruyɛfo no kokoram ho nhwehwɛmu a wɔde siw ano ho asɛm .

Sɛ wowɔ Pancoast tumor a, dɛn na wobɛhwɛ kwan?

Sɛ wohu sɛ wowɔ Pancoast tumor a, wo duruyɛfo no bɛboaboa ayaresa kuw bi a wɔayɛ ama w’ahiade pɔtee ano. Ebia w’ayaresa kuw no bi ne:

• Nnuruyɛfo a wɔyɛ ahurututu mu oprehyɛn.
• Ntini mu oprehyɛn ho animdefo.
• Oncologists , kyerɛ sɛ, oncologists a wɔyɛ wɔ aduruyɛ mu, oncologists a wɔyɛ oprehyɛn, ne oncologists a wɔde mframa a ano yɛ den di dwuma.

W’aduruyɛfo kuw no bɛkamfo ayaresa a egyina Pancoast akisikuru no kɛse, beae a ɛwɔ, ne sɛ ebia kokoram no atrɛw akɔ mmeae afoforo so akyerɛ.

Saa nnuaba yi nyin ntɛmntɛm dɛn?

Mpɛn pii no, Pancoast akisikuru no nyin nkakrankakra . Nanso, ɛntaa mma koraa sɛ akisikuru betumi anyin ntɛmntɛm. Wo duruyɛfo bɛhwɛ sɛnea akisikuru no nyin daa ansa na wɔasa no yare, bere a wɔresa no yare, ne bere a wɔasa no akyi.

Nkwa nna yɛ dɛn?

Wɔ mfe kakraa a atwam no mu no, mfiridwuma mu nkɔso ama nnipa dodow a wɔsa wɔn yare wɔ Pancoast akisikuru no mu no akɔ soro nkakrankakra. Nanso pii da so ara wɔ hɔ a ɛsɛ sɛ yesua fa yare yi ho. Mfe anum nkwa nna a nnipa a wɔwɔ Pancoast akisikuru a edi kan a wotumi sa oprehyɛn mu no yɛ 30% kosi 50% . Ɛno kyerɛ sɛ nnipa a wohu sɛ wɔwɔ Pancoast akisikuru a edi kan no mu bɛyɛ fã da so ara te ase wɔ mfe anum akyi wɔ bere a wɔahu sɛ wɔanya bi no. Nanso ɛho hia sɛ wokae: Saa nkwagye dodow yi yɛ akontaabu ara kwa. Wɔnkyerɛ wo bere tenten a wobɛtra ase anaa sɛnea ayaresa pɔtee bi bɛyɛ adwuma yiye ama wo. Wo ne wo duruyɛfo nkasa na woate sɛnea kokoram yi ka wo no ase ankasa.

Bere bɛn na ɛsɛ sɛ wohwehwɛ aduruyɛ mu afotu?

Sɛ wo mmati mu yɛ wo yaw kɛse, wo nsa yɛ wo yaw, wo nsa yɛ mmerɛw, anaa Pancoast tumor ho sɛnkyerɛnne afoforo a, ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara. Sɛ́ wobehu no ntɛm no yɛ ade titiriw.

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Sɛ wo anaa wo dɔfo bi wɔ Pancoast tumor a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm yi:

• Ɛhe na akisikuru no wɔ?
• So atrɛw akɔ ntini a atwa ho ahyia no mu?
• So atrɛw akɔ nipadua no afã horow a ɛwɔ akyirikyiri?
• Kokoram fã bɛn na mewɔ?
• Ayaresa ahorow bɛn na mewɔ?
• So metumi ayɛ adwuma bere a wɔreyɛ me ayaresa no?
• Bere tenten ahe na ayaresa taa gye?
• M’adwene te dɛn?

So eyi yɛ Pancoast tumor anaasɛ ntini a ɛyɛ pinched?

Nnipa binom a wɔwɔ Pancoast tumors ka sɛ wɔn sɛnkyerɛnne ahorow no fii ase wɔ "pinched nerve" nkate mu . Sɛ wowɔ ɛyaw a ɛte sɛɛ na ɛtra hɔ bɛboro adapɛn abien a, ma oduruyɛfo nhu. Ebia ɛnyɛ nea ɛfata.

Nkrasɛm a Etwa To a Wɔde Kɔ Fie

Pancoast tumors fi ase wɔ w’ahurututu no atifi. Ɛsono wɔn wɔ ahurututu mu akisikuru ahorow afoforo ho efisɛ ɛyɛ den sɛ wobehu wɔ mfiase. Sɛ wuhu sɛ wowɔ Pancoast tumor a, ebetumi ayɛ osuahu a ɛyɛ basaa kɛse. Ebetumi ayɛ den sɛ wobɛyɛ nea wobɛyɛ akyi.

Nanso kae sɛ wo duruyɛfo wɔ hɔ sɛ ɔbɛboa wo. Bisa no ma ɔmma no nsɛm pii fa wo tebea pɔtee no ho. Sɛ wubetumi a, kɔka kuw bi a wɔboa ho, ankasa anaa intanɛt so. Sɛ wo ne afoforo a wɔrefa nneɛma koro no ara a worefa mu no bɛkasa a, ebetumi ayɛ nea mfaso wɔ so kɛse ama w’adwene, nkate, ne honhom fam akwahosan. Mma wo nkutoo nhu amane da.

 Pancoast tumor, ahurututu mu kokoram, mmati mu yaw, kokoram ho sɛnkyerɛnne, kokoram ayaresa, ahurututu mu kokoram, mmati mu yaw