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Erschienen in: Zeitschrift für Pneumologie 6/2020

12.11.2020 | Computertomografie | CME

Lokaltherapie solitärer intrapulmonaler maligner Rundherde

verfasst von: J. op den Winkel, F. Eichhorn, L. A. Fischer, S. Rieken, Prof. Dr. H. Winter

Erschienen in: Zeitschrift für Pneumologie | Ausgabe 6/2020

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Zusammenfassung

Definition

Intrapulmonale Rundherde stellen in der Regel einen Zufallsbefund im Röntgenbild oder Computertomogramm des Thorax dar. Sie sind definiert als relativ gut abgegrenzte Läsionen von bis zu 3 cm Durchmesser, die allseits von Lungengewebe umgeben sind. Die Wahrscheinlichkeit für das Vorliegen eines malignen Tumors steigt mit ihrer Größe. Rundherde ab 1 cm Durchmesser bedürfen der aktiven Abklärung.

Therapie

Zur Behandlung solitärer maligner Tumoren steht für Patienten ohne nennenswert erhöhtes Operations- und Narkoserisiko der chirurgische Eingriff an erster Stelle. Patienten, die aus funktionellen Gründen für einen solchen nicht geeignet sind, können mit Radiofrequenzablation (RFA) oder die stereotaktische Radiotherapie (SBRT) behandelt werden. In diesen Fällen müssen vor Therapiebeginn die Malignität nachgewiesen oder zumindest über einen begrenzten Zeitraum eine Größenzunahme der Läsion dokumentiert worden sein.

Outcome

In Bezug auf die lokale Tumorfreiheit ist die Operation unter den Voraussetzungen einer R0-Resektion den anderen Verfahren überlegen.
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Metadaten
Titel
Lokaltherapie solitärer intrapulmonaler maligner Rundherde
verfasst von
J. op den Winkel
F. Eichhorn
L. A. Fischer
S. Rieken
Prof. Dr. H. Winter
Publikationsdatum
12.11.2020
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Pneumologie / Ausgabe 6/2020
Print ISSN: 2731-7404
Elektronische ISSN: 2731-7412
DOI
https://doi.org/10.1007/s10405-020-00351-4

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