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China Medical Concierge -Shanghai, Shanghai (2026)

22/09/2026

Stage IA2 NSCLC, VATS Segmentectomy with ERAS Protocol
Dr. Zhou Yongxin — Tongji Hospital, Tongji University, Shanghai 🏥 Need medical care in Shanghai?
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A 55-year-old male retired engineer from Indonesia presented with a 19mm solid pulmonary nodule in the left upper lobe, identified on a routine health screening CT. PET-CT showed mild FDG uptake. CT-guided biopsy confirmed stage IA2 adenocarcinoma. His local thoracic surgeon had recommended open lobectomy, citing the nodule's location near the hilum. Concerned about the recovery time and impact on his quality of life, he sought a second opinion on whether a less invasive approach was feasible.

Dr. Zhou Yongxin reviewed the CT, PET-CT, biopsy pathology, and pulmonary function tests. Three-dimensional CT reconstruction confirmed that the tumor was confined to the apicoposterior segment of the left upper lobe with adequate surgical margins achievable by segmentectomy. He recommended VATS segmentectomy — a parenchyma-sparing minimally invasive resection — combined with the department's full ERAS perioperative protocol, avoiding the need for open surgery.

Surgery: Left upper lobe VATS apicoposterior segmentectomy; 90-minute procedure.

The patient was mobilized on the evening of surgery. The chest drain was removed on day 2, and he was discharged on day 3 — compared to the 7–10 day stay anticipated with open lobectomy. Pathology confirmed complete resection with clear margins and no lymph node involvement. Molecular profiling showed EGFR exon 19 deletion; adjuvant osimertinib was initiated.

At 12-month follow-up, the patient remained disease-free with excellent lung function and had resumed his regular daily activities within 3 weeks of surgery.

Minimally invasive segmentectomy combined with ERAS protocols — in the hands of a surgeon committed to the "minimally invasive — precision — rapid recovery" philosophy — achieves oncological equivalence to open lobectomy while dramatically reducing recovery time and preserving quality of life.

21/09/2026

Persistent Part-Solid Pulmonary Nodule, VATS Segmentectomy & Post-Surgical Rehabilitation
Dr. Xia Jinjing — Shanghai Chest Hospital, Shanghai 🏥 Need medical care in Shanghai?
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A 48-year-old female nurse from the Philippines presented with a persistent 14mm part-solid pulmonary nodule in the right upper lobe, identified incidentally on a health screening CT two years prior. Serial CT surveillance at 6-month intervals had shown a slowly enlarging solid component, now measuring 7mm. Two local pulmonologists had offered conflicting advice — one recommending continued surveillance, the other recommending lobectomy. Concerned by the uncertainty, she sought a specialist opinion on the optimal management approach.

Dr. Xia Jinjing reviewed the serial HRCT imaging in detail, assessing nodule morphology, density distribution, solid component growth trajectory, and vascular supply. She identified features consistent with a lepidic-predominant adenocarcinoma and recommended VATS segmentectomy — a parenchyma-sparing resection that would achieve complete oncological resection while preserving maximum lung function — rather than the more extensive lobectomy that had been proposed.

Surgery: Right upper lobe VATS segmentectomy under general anaesthesia; 2-hour procedure.

Pathology confirmed stage IA1 lepidic-predominant adenocarcinoma with clear margins and no lymph node involvement. No adjuvant therapy was required. Dr. Xia initiated a structured 8-week post-surgical pulmonary rehabilitation program — including respiratory physiotherapy, progressive exercise training, and return-to-activity planning — which the patient continued at home with remote guidance.

At 6-month follow-up CT, no residual or recurrent disease was identified. Lung function testing showed 94% of predicted FEV1 — an excellent functional outcome reflecting both the parenchyma-sparing surgical approach and the structured rehabilitation program.

In persistent part-solid nodules with a growing solid component, timely expert assessment — distinguishing the optimal surgical approach and pairing it with structured post-surgical rehabilitation — achieves both oncological cure and preservation of lung function.

20/09/2026

Double-Hit Diffuse Large B-Cell Lymphoma (DLBCL), Molecular Subtyping-Guided Precision Treatment
Prof. Zhao Weili — Ruijin Hospital, Shanghai Jiao Tong University School of Medicine 🏥 Need medical care in Shanghai?
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A 41-year-old male architect from Singapore presented with rapidly progressive diffuse large B-cell lymphoma (DLBCL) that had failed to achieve complete remission after two cycles of standard R-CHOP. Repeat biopsy and molecular profiling at his local centre had been reported as "DLBCL, NOS" without further subtyping. Given the poor early response, his oncologist recommended escalation to salvage chemotherapy, but acknowledged uncertainty about the optimal approach. The family sought a second opinion from a specialist in lymphoma molecular subtyping.

Prof. Zhao Weili reviewed the original biopsy material, immunohistochemistry, FISH, and gene expression profiling. Her team identified a double-hit lymphoma (DHL) with concurrent MYC and BCL2 rearrangements — a high-risk molecular subtype that is well-recognized to be refractory to standard R-CHOP and requires intensified treatment. She recommended DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab) — the evidence-based regimen of choice for double-hit DLBCL — followed by consolidative autologous stem cell transplantation in remission.

After four cycles of DA-EPOCH-R, PET-CT confirmed complete metabolic response. The patient proceeded to ASCT and remained in complete remission at 24-month follow-up with no evidence of disease recurrence.

In DLBCL, accurate molecular subtyping is not optional — it is the foundation of treatment selection. Double-hit lymphoma requires a fundamentally different treatment approach from standard DLBCL, and identifying it requires the precision diagnostic expertise that Prof. Zhao's team has pioneered.

19/09/2026

Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL), CD19-Targeted CAR-T Therapy Prof. Liu Peng — Zhongshan Hospital, Fudan University, Shanghai 🏥 Need medical care in Shanghai?
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A 45-year-old female university lecturer from Malaysia presented with diffuse large B-cell lymphoma (DLBCL) that had relapsed after two prior lines of therapy — R-CHOP first-line and R-ICE salvage chemotherapy. PET-CT confirmed widespread nodal and extranodal disease progression. Her oncologist had advised that further conventional chemotherapy was unlikely to achieve durable remission and that autologous stem cell transplantation was no longer feasible given chemotherapy-refractory disease. She sought evaluation for CAR-T therapy at Zhongshan Hospital.

Prof. Liu Peng reviewed the biopsy pathology, molecular profiling, PET-CT imaging, and complete treatment history. He confirmed eligibility for CD19-targeted CAR-T therapy and proceeded with leukapheresis using a domestically produced CAR-T product — one whose clinical development his team had been instrumental in bringing to regulatory approval.

CAR-T cells were manufactured and infused following lymphodepletion chemotherapy. The patient was monitored as an inpatient during the acute post-infusion period. Cytokine release syndrome was grade 2, managed with tocilizumab with prompt resolution.

At day-30 PET-CT, a complete metabolic response was confirmed. At 18-month follow-up, the patient remained in sustained complete remission with no evidence of disease recurrence and had returned to full-time teaching.

In relapsed/refractory DLBCL after two or more prior lines, CD19-targeted CAR-T therapy — delivered by a team that pioneered China's first domestically approved lymphoma CAR-T product — can achieve durable complete remission where conventional therapy has failed.

18/09/2026

High-Risk AML, Haploidentical Stem Cell Transplantation
Prof. Wang Jianmin — Changhai Hospital, Naval Medical University, Shanghai 🏥 Need medical care in Shanghai?
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A 38-year-old female graphic designer from Indonesia presented with newly diagnosed acute myeloid leukemia (AML) with complex karyotype and TP53 mutation — a high-risk molecular profile associated with poor response to standard chemotherapy and high relapse risk. She achieved complete remission after induction, but her haematologist advised that consolidation chemotherapy alone carried an unacceptably high relapse risk and that allogeneic stem cell transplantation was essential. No matched sibling donor was available, and the unrelated donor search was unsuccessful. She was referred to Changhai Hospital for haploidentical transplantation assessment.

Prof. Wang Jianmin reviewed the bone marrow biopsy, cytogenetics, molecular profiling, and post-induction MRD status. He confirmed that haploidentical transplantation using her younger brother as a half-matched donor was the optimal curative strategy, and proceeded with a myeloablative conditioning regimen followed by haploidentical HSCT with an optimized GvHD prophylaxis protocol.

Engraftment was confirmed on day +16. Early GvHD was grade I skin involvement, which resolved with topical therapy. Post-transplant MRD monitoring confirmed sustained molecular remission.

At 24-month follow-up, the patient remained in complete molecular remission with full donor chimerism and had returned to full-time work. No chronic GvHD of clinical significance was present.

For high-risk AML patients without a matched donor, haploidentical transplantation — performed by an experienced team with optimized GvHD protocols — offers a genuine curative pathway where no other option exists.

17/09/2026

High-Risk Newly Diagnosed Multiple Myeloma, Quadruplet Induction + ASCT
Prof. Hou Jian — Renji Hospital, Shanghai Jiao Tong University School of Medicine 🏥 Need medical care in Shanghai?
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A 52-year-old male secondary school teacher from Thailand presented with newly diagnosed multiple myeloma following a pathological vertebral fracture and progressive back pain. Investigations revealed R-ISS Stage III disease with high-risk cytogenetics — del(17p) and gain(1q) — and significant renal impairment (eGFR 28 mL/min). His local oncologist had proposed standard VRd induction but acknowledged limited experience with high-risk disease. The family sought a second opinion from a specialist with international myeloma expertise.

Prof. Hou Jian reviewed the M-protein studies, bone marrow biopsy, FISH cytogenetics, whole-body PET-CT, and renal function. Recognizing the high-risk cytogenetic profile and the need for the deepest possible early response, he recommended Dara-VRd quadruplet induction — the most intensive evidence-based regimen for transplant-eligible newly diagnosed myeloma — with renal dose modification, followed by autologous stem cell transplantation and lenalidomide maintenance.

After four cycles of Dara-VRd, a very good partial response (VGPR) was achieved with significant renal recovery (eGFR 54 mL/min). The patient proceeded to ASCT and achieved stringent complete response (sCR) with MRD negativity post-transplant. At 18-month follow-up on lenalidomide maintenance, he remained in sustained MRD-negative complete remission with stable renal function and had returned to full-time teaching.

In high-risk newly diagnosed myeloma with del(17p), quadruplet induction followed by ASCT — guided by a physician with IMWG-level expertise — maximizes the depth of response and offers the best foundation for durable disease control.

16/09/2026

Relapsed/Refractory Multiple Myeloma, BCMA-Targeted CAR-T Therapy
Prof. Shi Jumei — Oriental Hospital, Tongji University, Shanghai 🏥 Need medical care in Shanghai?
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A 58-year-old male architect from Vietnam presented with relapsed multiple myeloma following four prior lines of therapy, including bortezomib, lenalidomide, daratumumab, and autologous stem cell transplantation. Bone marrow biopsy confirmed 45% plasma cell infiltration with high-risk cytogenetics (del17p). His oncologist had advised that no further standard options remained. He sought a second opinion at Oriental Hospital.

Prof. Shi Jumei reviewed the bone marrow biopsy, M-protein studies, cytogenetics, and complete treatment history. Given the heavily pre-treated, high-risk disease, she recommended BCMA-targeted CAR-T cell therapy — an approach she had developed expertise in during her training at a top US myeloma center — as the optimal strategy to achieve deep remission.

Leukapheresis was performed and CAR-T cells were manufactured and infused following lymphodepletion chemotherapy. The patient was monitored as an inpatient during the acute post-infusion period.

At day-28 assessment, a stringent complete response (sCR) was confirmed with MRD negativity on next-generation sequencing. Cytokine release syndrome was grade 1 and resolved without escalation. At 12-month follow-up, the patient remained in sustained MRD-negative complete remission with no evidence of disease progression.

For heavily pre-treated myeloma patients with high-risk cytogenetics, BCMA-targeted CAR-T therapy — delivered by a physician with dedicated international myeloma training — can achieve deep, durable remission where all prior therapies have failed.

15/09/2026

Elderly Acute Myeloid Leukemia (AML), Venetoclax + Azacitidine
Prof. Li Junmin — Ruijin Hospital, Shanghai Jiao Tong University School of Medicine 🏥 Need medical care in Shanghai?
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A 72-year-old retired engineer from the Philippines presented with a 6-week history of progressive fatigue, recurrent low-grade fever, and easy bruising. Bone marrow biopsy confirmed de novo AML with FLT3-ITD mutation and intermediate-risk cytogenetics. His cardiologist had documented moderate left ventricular dysfunction, and his treating haematologist advised that intensive induction chemotherapy carried prohibitive cardiac risk. The family sought a second opinion at Ruijin Hospital.

Prof. Li Junmin reviewed the bone marrow biopsy, molecular profiling, cardiac assessment, and performance status. He recommended a low-intensity regimen of venetoclax combined with azacitidine, with gilteritinib added given the FLT3-ITD mutation — a precision-guided approach designed to achieve remission without the toxicity of intensive chemotherapy.

Treatment was initiated as an inpatient cycle with subsequent outpatient maintenance.

At day-28 bone marrow assessment, complete remission with incomplete haematological recovery (CRi) was confirmed. By cycle 3, full complete remission (CR) was achieved with MRD negativity on molecular testing. The patient tolerated treatment well with no cardiac events. At 12-month follow-up, he remained in sustained remission with stable cardiac function and an excellent quality of life.

In elderly AML patients with comorbidities, precision-guided low-intensity therapy — venetoclax-based combinations tailored to the patient's molecular profile — can achieve deep remission while preserving quality of life and avoiding the toxicity of intensive chemotherapy.

14/09/2026

Refractory Immune Thrombocytopenia (ITP), TCM-Western Integrative Therapy
Prof. Zhou Yongming — Yueyang Hospital, Shanghai University of Traditional Chinese Medicine 🏥 Need medical care in Shanghai?
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A 34-year-old female nurse from Indonesia presented with a 3-year history of chronic immune thrombocytopenia (ITP) refractory to first- and second-line Western therapy. Despite two courses of high-dose corticosteroids, IVIG, and a trial of a TPO receptor agonist, her platelet counts remained persistently below 20 × 10⁹/L with recurrent mucosal bleeding episodes. Multiple haematologists had recommended splenectomy, which she declined. She sought a second opinion at Yueyang Hospital.

Prof. Zhou Yongming reviewed her complete haematological records, bone marrow biopsy, and prior treatment history. He identified a pattern of Kidney Yin deficiency with Blood stasis on TCM assessment, and recommended an individualized integrative protocol combining a tailored herbal formula targeting immune dysregulation and platelet production with low-dose eltrombopag, avoiding further high-dose immunosuppression.

Treatment was initiated on an outpatient basis with remote follow-up.

At 3-month review, platelet counts had risen to 68 × 10⁹/L with no bleeding episodes. By 6 months, counts had stabilized above 80 × 10⁹/L, eltrombopag was tapered successfully, and the patient reported significant improvement in fatigue and quality of life. Splenectomy was avoided.

Individualized TCM herbal therapy, precisely matched to the patient's pattern diagnosis and disease stage, can achieve durable platelet responses in refractory ITP — reducing steroid dependence and sparing patients from surgical intervention.

13/09/2026

Condylar Hyperplasia, Unilateral Facial Asymmetry with Progressive Crossbite Dr. Shen Guofang — Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine 🏥 Need medical care in Shanghai?
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A 22-year-old female marketing professional from Malaysia presented with progressive unilateral facial asymmetry, a worsening lateral open bite, and chin deviation to the right side that had developed over the preceding 4 years. Bone scintigraphy confirmed active unilateral left condylar hyperplasia with ongoing condylar growth. She had been advised to "wait until growth stops" by multiple clinicians but sought a second opinion through CMCS as the asymmetry continued to worsen.

Dr. Shen Guofang reviewed the scintigraphy, CBCT imaging, and cephalometric analysis. Given the confirmed active condylar growth, he recommended high condylectomy of the hyperplastic left condyle to arrest the pathological growth, followed by a staged orthognathic correction once growth had stabilized. The condylectomy was performed as a day surgical procedure.

Surgery: Left high condylectomy under general anaesthesia; day surgery.

At 6-month post-condylectomy scintigraphy, condylar activity had normalized bilaterally, confirming arrest of pathological growth. Facial asymmetry progression had halted. The patient subsequently underwent bimaxillary orthognathic surgery 12 months later to correct the residual skeletal asymmetry, with excellent aesthetic and functional outcomes at final review.

Active condylar hyperplasia requires timely high condylectomy to arrest pathological growth before definitive orthognathic correction — a staged approach that prevents further asymmetry and optimizes the final surgical outcome.

China Medical Concierge -Shanghai

22/09/2026

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