Carcinoma de Pequena Células em Esôfago: Relato de Caso e Revisão
DOI:
https://doi.org/10.32635/2176-9745.RBC.2000v46n2.3426Palavras-chave:
Carcinoma de Pequenas Células, Carcinoma de Pequenas Células do Esôfago, Carcinoma de EsôfagoResumo
O caso de um paciente do sexo masculino com 54 anos, portador de carcinoma de pequenas Células primitivo em terço inferior de esôfago. As manifestações iniciais da doença se caracterizaram por emagrecimento acentuado e dores epigástricas com 3 meses de evolução. Ao exame físico observamos sinais evidentes de doença consuntiva. O estadiamento oncológico revelou acometimento secundário de linfonodos para-aórticos, mesentéricos e do tronco celíaco (doença extensa), além de possível invasão de aorta descendente. O tratamento baseou-se na quimioterapia com cisdiaminodicloroplatinum e etoposide, obtendo-se remissão clínica completa com três ciclos. Como consolidação do resultado, o paciente recebeu radioterapia externa dirigida ao local do tumor primário, porém a resposta obtida não se manteve, havendo progressão local e sistêmica após 40 dias do término da radioterapia. O óbito se deu em função de infecção respiratória e múltiplas metástases 9 meses do diagnóstico. Nós discutimos o mau prognóstico deste tipo de tumor, sobretudo em função do comportamento biológico agressivo e fazemos uma análise crítica da orientação terapêutica proposta, concluindo que o tratamento principal para os carcinomas de pequenas células de esôfago locorregionalmente avançado deve ser baseado na quimioterapia.
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