Diagnosis: Small cell anaplastic carcinoma in the lung - YG

A 31-year-old man experienced pain in his back, high fever, and cough in early September, 1995. He presented on 29 September 1995 to a chest disease specialist. Bronchoscopy and biopsy were performed. Histopathological examination of the biopsy specimen revealed the diagnosis as small cell anaplastic carcinoma of the lung ( Appendix YG1 ).

The patient was then taken to Istanbul University Medical Faculty on 10 October 1995. Further examination demonstrated metastatic lesion in the third dorsal vertebra, and the case was considered inoperable. Chemotherapy was recommended but the patient declined. He was discharged with symptomatic medicines. When his pain increased, the patient was prescribed narcotic drugs.

The patient was taken to Dr. Ozel on 24 October 1995. He was experiencing sharp pain in his left armpit, chest and in his back as well as dyspnea. Auscultation revealed no breathing sound in the left hemi-thorax, and dullness. He was dizzy because of the narcotic medicines he was taking. He was having attacks of cough. The x-ray taken on the same day revealed a tumoral mass and atelectasis in the left lung ( Appendix YG2 ). The patient was injected with 0.3 cc of N.O.I., and his body temperature increased to 38.2o C. A regular treatment scheme with a single daily dose of 0.3 cc of N.O.I. started; this would be given six days a week. He was recommended to adjust the dosage according to maximum fever, and to have a follow up x-ray taken if the pain ceased.

Twelve days later the patient stopped experiencing any pain. Following Dr. Ozel's instruction, he had an x-ray taken on 6 November 1995. The roentgenogram demonstrated remarkable regression of the tumoral mass in the left lung ( Appendix YG3 ).

The patient continued the N.O. treatment. After 10 April 1996 the patient had no fever following N.O.I. injections. He presented to Dr. Ozel on 10 May 1996 with an x-ray taken on 7 May 1996 ( Appendix YG4 ). The radiograph showed that the tumoral mass had completely disappeared. The patient had no pain and no dyspnea. Auscultation revealed that the left lung was participating in breathing normally. His general health condition was excellent. The patient was placed on a maintenance treatment scheme with one injection of 0.3 cc dose of N.O.I. every two days. The patient received the maintenance therapy for another 3 months, and his therapy ended.

Dr. Ozel last heard about him in May, 2006; he was in remission.