Respir Case Rep. 2014; 3(3): 186-190 | DOI: 10.5505/respircase.2014.86580

Ýnvaziv zigomikozun eþlik ettiði küçük hücreli akciðer kanseri olgusu

Evrim Eylem Akpýnar¹, Derya Hoþgün¹, Baþar Kaya², Hande Ezeraslan³, Semra Tunçbilek⁴, Handan Doðan⁵, Meral Gülhan^1
1Ufuk Üniversitesi, Týp Fakültesi, Göðüs Hastalýklarý Anabilim Dalý, Ankara, Türkiye
²Ufuk Üniversitesi, Týp Fakültesi, Plastik Ve Rekonstrüktif Cerrahi Anabilim Dalý, Ankara, Türkiye
³Ufuk Üniversitesi, Týp Fakültesi, Kulak-burun-boðaz Hastalýklarý Anabilim Dalý, Ankara, Türkiye
⁴Ufuk Üniversitesi, Týp Fakültesi, Klinik Mikrobiyoloji Ve Enfeksiyon Hastalýklarý Anabilim Dalý, Ankara, Türkiye
⁵Ufuk Üniversitesi, Týp Fakültesi, Patoloji Anabilim Dalý, Ankara, Türkiye

Ýnvaziv bir fungal enfeksiyon olan zigomikoz, progresif seyreder ve sýklýkla mortalite ile sonuçlanýr. Diabetes mellitus ve malign hematolojik hastalýklar en sýk görülen predispozan risk faktörleridir. Zigomikoz, solid tümörlerle birlikte nadiren görülür. Bu yayýnda sunulan olguya, sýnýrlý evre küçük hücreli akciðer kanseri tanýsý ile kemoradyoterapi baþlandý. Hasta radyasyon özofajiti nedeniyle oral dekzametazon kullanýyordu ve diabetes mellitusu vardý. Hasta, üçüncü kür kemoterapi sonrasýnda göz çevresinde aðrý yakýnmasýyla baþvurdu. Sert damakta nekroz tesbit edildi ve biyopsi alýndý. Biyopsi materyalinin incelemesinde dallanan hifalar görüldü ve kültürde Rhizomucor spp. üredi. Ýnvaziv zigomikoz tanýsýyla kombine sistemik antifungal, topikal antifungal ve cerrahi debridman uygulandý. Tedaviyle belirgin klinik düzelme izlendi. Bu yazýnýn amacý küçük hücreli akciðer kanserli bir olguda; sert damakta geliþen, cerrahi debridman, topikal ve sistemik antifungal tedaviyle seyri iyi olan bir invaziv zigomikoz olgusunu sunarak, solid tümörlerle birlikte nadir görülen bu klinik tablonun önemini vurgulamaktýr.

Anahtar Kelimeler: akciðer kanseri, invaziv fungal enfeksiyon, kombine tedavi

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A case of small cell lung cancer associated with invasive zygomycosis

Evrim Eylem Akpýnar¹, Derya Hoþgün¹, Baþar Kaya², Hande Ezeraslan³, Semra Tunçbilek⁴, Handan Doðan⁵, Meral Gülhan^1
1Ufuk University, Department Of Chest Diseases, Ankara, Turkey
²Ufuk University, Department Of Plastic And Reconstructive Surgery, Ankara, Turkey
³Ufuk University, Department Of Department Of Ear-nose-throat, Ankara, Turkey
⁴Ufuk University, Department Of Department Of Clinical Microbiology And Infectious Diseases, Ankara, Turkey
⁵Ufuk University, Department Of Pathology, Ankara, Turkey

Zygomycosis is an invasive fungal infection with a progressive clinical course and commonly concluding with mortality. Diabetes mellitus and malignant hematological diseases are the most common predisposing risk factors. It is rarely associated with solid tumors. Concomitant chemoradiotherapy had been applied to the presented patient with the diagnosis of limited small cell lung cancer. He had diabetes mellitus and was using dexamethasone for radiation esophagitis. He admitted with the complaint of periorbital pain after the third cycle of chemotherapy. Palatal necrosis was detected and a biopsy was taken from the lesion. Branching hyphae were observed on the microscopic evaluation and Rhizomucor spp. proliferated on culture. He was diagnosed with invasive zygomycosis and was treated with combined systemic antifungal treatment and topical antifungal in addition to surgical debridement, which resulted in near-complete healing. The aim of this report was to emphasize the clinical importance of invasive zygomycosis, which is rarely seen with solid tumors by presenting a case that had a favorable clinical course by means of combined systemic antifungal treatment and surgical debridement.

Keywords: lung cancer, invasive fungal infection, combined treatment

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