말기 유방암 환자에서 발생한 흉막 전이에 의한 거대 종양 1예와 호흡곤란의 치료 = A Case of a Huge Mass Due to Pleural Metastasis and Management of Dyspnea in a Patient with Terminal Breast Cancer

국문 초록 (Abstract)

유방암 환자의 흉막 전이는 흔한 소견이다. 흉수가 가장 흔한 증상이고 흉수를 동반하지 않는 흉막 결절이나 흉막 판은 비교적 드물다. 본 환자는 말기 유방암으로 인해 흉수를 동반하지 않는 빠른 속도로 악화되는 거대 흉막 종양이 생겨났고 그로 인해 심한 호흡곤란을 경험했던 환자로 보기 드문 증례로서 보고를 하며 이와함께 말기암환자의 호흡곤란의 치료에 대해 고찰해 보고자 한다.

다국어 초록 (Multilingual Abstract)

Pleural metastasis from breast cancer is a common manifestation. While pleural effusion is the most frequent finding, it is relatively rare for pleural nodularity and plaque that do not accompany pleural effusion. We report a patient with a rapidly growing huge pleural mass without pleural effusion caused by breast cancer. The patient was treated for severe dyspnea caused by the pleural mass. Along with the case report, we performed a systematic review of management of dyspnea in terminal cancer patients.

참고문헌 (Reference)

1 황인철, "말기암환자에서 불응성 호흡곤란 완화를 위한 Furosemide 흡입치료 -대한가정의학회 완화의학연구회 세미나에 기초한-" 한국호스피스완화의료학회 13 (13): 252-256, 2010

2 Jung JI, "Thoracic manifestations of breast cancer and its therapy" 24 : 1269-1285, 2004

3 McIver B, "The use of chlorpromazine for symptom control in dying cancer patients" 9 : 341-345, 1994

4 Castellani C, "Single cardiac metastasis from colorectal cancer:an unusual localization" 14 : 474-476, 2013

5 Miyazaki H, "Pleural cavity angiosarcoma arising in chronic expanding hematoma after pneumonectomy" 42 : 1576-1579, 2011

6 Nava S, "Palliative use of non-invasive ventilation in end-of-life patients with solid tumours: a randomised feasibility trial" 14 : 219-227, 2013

7 Maltoni M, "Palliative sedation in end-of-life care and survival: a systematic review" 30 : 1378-1383, 2012

8 Campbell ML, "Oxygen is nonbeneficial for most patients who are near death" 45 : 517-523, 2013

9 Navigante AH, "Midazolam as adjunct therapy to morphine in the alleviation of severe dyspnea perception in patients with advanced cancer" 31 : 38-47, 2006

10 Kuwabara H, "Malignant pleural mesothelioma forming a huge mediastinal mass and causing atrial fibrillation" 55 : 513-515, 2012

11 Ben-Aharon I, "Interventions for alleviating cancer-related dyspnea: a systematic review and meta-analysis" 51 : 996-1008, 2012

12 Ben-Aharon I, "Interventions for alleviating cancer-related dyspnea: a systematic review" 26 : 2396-2404, 2008

13 Chang JC, "Hypoglycemia in a patient with a huge malignant solitary fibrous tumor of the pleura" 57 : 791-793, 2007

14 Demura S, "Giant cell tumor expanded into the thoracic cavity with spinal involvement" 35 : e453-e456, 2012

15 Gamborg H, "Effect of intraoral and subcutaneous morphine on dyspnea at rest in terminal patients with primary lung cancer or lung metastases" 9 : 269-274, 2013

16 Man GC, "Effect of alprazolam on exercise and dyspnea in patients with chronic obstructive pulmonary disease" 90 : 832-836, 1986

17 Wang W, "Diagnosis of pleural cavity extraskeletal osteosarcoma: a case report and literature review" 33 : 202-205, 2010

18 Thomas JR, "Clinical management of dyspnoea" 3 : 223-228, 2002

19 Gasiorowski L, "An unusual case of giant primary mediastinal liposarcoma" 57 : 247-248, 2009

20 Bredin M, "A'Hern R. Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer" 318 : 901-904, 1999

21 Pandit S, "A rare mediastinal tumour in a young male mimicking massive pleural effusion" 29 : 66-69, 2012