• Title/Summary/Keyword: Mediastinal tumor

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Surgical Evaluation of Squamous Cell Carcinoma of the Lung (편평상피세포 폐암의 외과적 고찰)

  • An, Byeong-Hui;Mun, Hyeong-Seon;Na, Guk-Ju;Kim, Sang-Hyeong
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.179-186
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    • 1997
  • The frequency of primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with Lean 57.1) $\pm$ 7.15 and 80.5% (70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9'1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left slde in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in'16. 1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage olla 54.1% and stage lIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal Iymph node involvement was observed in 17 cases, and multi-level mediastinal Iymph node involvement in 23 cases. Lower paratracheal Iymph node and subcarinal Lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic Iymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95 $\pm$ 17.21 months. Overall one-year survival rate was 75.1 % and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage 1, 92.2% and 30.5% for st ge ll, and 61.2% and 17.4% for stage llla, respectively. These findings correlate survival rate with tumor size, mediastinal Iymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal Iymph node metastasis and complete surgical resection.

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Video Assisted Thoracoscopic Surgery, 31 Cases (비디오 흉강경을 이용한 흉부수술 31예)

  • Sung, Sook-Whan;Kim, Kwhan-Mien;Kim, Joo-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.468-473
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    • 1993
  • Background: Recent advance in video technology, endoscopic equipments, and surgical techniques have expanded the use of thoracoscopy from diagnosis of the pleural diseases to treatment of the various intrathoracic diseases. Video Assisted Thoracoscopic Surgery(VATS) is a pretty new and fascinating thoracic surgical modality, and so we present our early VATS resuls. Methods: Using Video Thoracoscopic techniques in 30 patients for 10 months from July 1992 to April 1993, we had performed a variety of procedures. These incuded (1) bleb resections in 18 patients (19 cases), (2) mediastinal tumor excision in 4, (3) lung biopsies for parenchymal pulmonary disease in 3, (4) pleural biopasies in 3, (5) pleural tumor excision in 1, (6) and pleuropericardial window in 1. Results: There were no mortality associated with the procedures. We had minor 8 complications; prolonged air leak in 3 patients, prolonged serous drainage in 2, recurrence of pneumothorax in 1, Honer's syndrome in 1, and hoarseness in 1 patient. None of the 30 patients had reverted to the conventional full thoracotomies. Mean postoperative hospital stay of non-complicated pneumothoraces was about 5 days, which was a little shorter than conventional thoracotomy group. Conclusion: Though we had somewhat higher postoperative complication rate due to lack of experiences in the begining, we were able to convince that VATS had benifical value for patients; lesser postoperative pain, shorter hospitalization, quicker recovery time, and cosmetically superior scar. The role of VATS can be expanded to the diagnosis and treatment of various thoracic diseases, even to the cardiovascular diseases, with satisfactory outcome and less postoperative morbidity.

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A GFP-labeled Human Colon Cancer Metastasis Model Featuring Surgical Orthotopic Implantation

  • Chen, Hong-Jin;Yang, Bo-Lin;Chen, Yu-Gen;Lin, Qiu;Zhang, Shu-Peng;Gu, Yun-Fei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4263-4266
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    • 2012
  • Colorectal cancer has become a major disease threatening human health. To establish animal models that exhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying the genesis and development effectively, but also provide ideal carriers for the screening of medicines and examining their therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressing green fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFP-labeled colon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and there were no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed in all model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at the same time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice died and the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth. Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesenteric lymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeled colon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibit similar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.

Significant Mismatch between FDG Uptake and Size after Chemotherapy in a Patient with Non-small Cell Lung Cancer (항암치료 후에 병변의 크기는 감소하였으나 FDG 섭취는 증가한 비소세포폐암 환자 1예)

  • Kwon, Seong-Young;Jeong, Shin-Young;Seo, Young-Soon;Ha, Jung-Min;Chong, A-Ri;Oh, Jong-Ryool;Song, Ho-Chun;Min, Jung-Joon;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.488-490
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    • 2008
  • A 75-year-old man with non-small cell lung cancer (NSCLC) underwent F-18 fluorodeoxyglucose (FDG) PET/CT for staging. PET/CT showed distant metastases to intra-abdominal lymph nodes (LNs) as well as bilateral mediastinal LNs (stage IV), He underwent PET/CT (restaging PET/CT) 1week after the completion of first-line chemotherapy (docetaxel+carboplatin). It showed markedly increased FDG uptake in primary tumor, whereas tumor size decreased significantly, compared to prior PET/CT. This lesion was aggravated on follow-up CT 3 months after the completion of chemotherapy. Although there are several reports that FDG PET has potential to evaluate early response to chemotherapy and prognosis, there are a few cases to show mismatch between FDG uptake and size on PET/CT. Thus we report a case of NSCLC showed increased FDG uptake of primary tumor while decreased tumor size on restaging PET/CT.

A Case of Combined Mixed Germ Cell Tumor and Angiosarcoma within the Mediastinum (종격동내 혼합 생식 세포종과 폐전이를 동반한 혈관육종이 동시에 존재한 중복암 1예)

  • Ryu, Hon-Mo;Choi, Hee-Jin;Shin, Ghung-Cheul;Chung, Jin-Hong;Lee, Kuan-Ho;Lee, Hyen-Woo;Lee, Dong-Hyup;Lee, Jung-Cheul;Han, Sung-Sae;Shim, Young-Ran;Kim, Dong-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.413-417
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    • 1994
  • We experienced one case of combined mixed germ cell tumor and angiosarcoma metastasis to the lung within the mediastinum. He was 19-year-old male, complained of hemoptysis, coughing, purulent sputum and weight loss for 2 months prior to adimission. The patient underwent open thoracotomy, but we couldn't resect the mass completely, because of tumor encroachment on adjacent mediastinal structures. He began radiation therapy involving the right lung but had no response to therapy.

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A Case Report of Thymic Carcinoid Tumor Associated with Cushing's Syndrome: Possible Corticotropin-Releasing Hormone Secreting Tumor (쿠싱 증후군 일으킨 카르시노이드종양의 1예 보고: 코르티코트로핀분비호르몬 분비하는 종양 의증)

  • Chon Soon-Ho;Ro Sun-Kyun;Oh Young-Ha;Kang Jun-Goo;Yeom Jong-Hoon;Lee Chul-Burm
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.795-798
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    • 2006
  • Thymic carcinoid tumor associated with Cushing's syndrome is a rare disease with a poor prognosis. Thymic carcinoid with Cushing's syndrome caused by CRH (corticotropin-releasing hormone) production is even rarer. We report a 58-year-old woman with a huge anterior mediastinal mass. Five months after thymectomy the patient was readmitted with symptoms of generalized edema and dyspnea. Recurrence and metastases were discovered and Cushing's syndrome diagnosed.

Current Status of General Thoracic Surgery in Korea (한국의 일반 흉부수술 현황)

  • 전영진
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.504-510
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    • 1992
  • Overall 25,095 cases of general thoracic surgery were analysed, which were performed by 48 institutes in Korea during recent 6 years[242 hospital-years]. The proportions of tumorous disease and infectious disease to be operated were 6,864 cases[27.4%] and 6,775 cases [27.0%], The most common organ involved for operation was lung-bronchus 16,542 cases [69.5%], and remainders were pleura 2,500 [10.0%], esophagus 2,433[9.7%], mediastinum 1,902[7.6%], chest wall 1,297 [5.2%], and diaphragm 421 [1.7%] in order. Among 6,864 cases of tumorous diseases, the most common causes for operation were lung-bronchus tumor 3132 cases [45.6%] and most of them were lung cancer 2,731 cases [88.7%]. In the 2,019 cases of primary lung cancer with known cell type, squamous cell carcinoma 1,296 cases [64.2%] and adenocarcinoma 460 cases [22.8%] were the most. The common types in the 1,207 cases of mediastinal tumor with known cell type were neurogenic tumor 348 cases [28.8%], thymoma 311 [25.8%], and teratoma 252[20.9%]. The annual cases of operation for tumorous disease including malignant tumor were increased steadily. Operation for infectious lung diseases [including bronchiectasis and tuberculosis] were about twice common than infectious pleural disease [i.e. empyema], and operations for tuberculous disease occupied about half cases of infectious lung disease. In 11,456 cases of other disease entities, excluding tumorous and infectious disease, there were bullous lung disease 9,074 cases[79.2%], benign esophageal disease 484[4.2%], myasthenia gravis 356[3.1%], chest wall deformity 483[4.2%], and diaphragmatic lesion 421[3. 7%] in order. We propose that above results for inquiry can be used as the basic data of general thoracic surgery in Korea.

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Development of Animal Model for Orthotopic Non-Small Cell Lung Cancer in Nude Rat (정위성 비소세포폐암의 동물 모델의 개발)

  • 김진국;김관만
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.566-572
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    • 1997
  • A major obstacles to evaluation of newly-developed treatment strategy for human lung cancer has been the lack of appropriate experimental animal models. We describe a new experimental model of orthotopically-developed non-small cell lung cancer in nude rat, involving inoculation of tumor cell suspension by thoracotomy. Over 40 direct implantation to the periphery of the lung has been performed to date, each requiring less than'1 hour for completion. This model has been used to perform a series of experiments to investigate whether the rat lung and surrounding structures trapped tumor cells with 2 different non-small cell lung cancer cell lines(NCI-H46O and NCI-H1299). Every animal showed development of tumor masses, which were loculated at the periphery of the lung karenchyma and identified also by radiography. After 3 weetu of the inoculation, tumor develop meat at the mediastinal strutures were identified. The life expectancies of the victims were different between the cell lines, but were approximately 5 weeks when NCI-H46O cell line was used. This new orthotopic lung cancer model may be facilitate future studies of the new therapeutics of localized non-small cell lung cancer .

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Ventricular Septal Defect Associated with Aortic Insufficiency (대동맥판막 폐쇄부전이 동반된 심실중격결손증의 외과적 치료)

  • 두홍서
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1111-1116
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    • 1988
  • Neurofibromatosis is very rare syndrome characterized by abnormal cutaneous pigmentation and numerous skin tumors was described by Smith in 1849, which is inherited as an autosomal dominant trait. Von Recklinghausen reported 2 cases of multiple skin and subcutaneous tumors in 1982. Malignant peripheral nerve tumors, although generally rare, are one of the most characteristic malignant tumors associated with Neurofibromatosis. We have experienced 3 cases of malignant Schwannoma in neurofibroma patients from 1982 to 1988 for 6 years at Thoracic and Cardiovascular surgery department, College of Medicine, Yonsei University, Seoul, Korea. l. One is 62 years old female who was taken total hysterectomy followed by irradiation treatment due to Uterine Carcinoma 21 years ago. She had a large bulging mass on left anterior chest wall and was taken enbloc resection of tumor including rib confirmed malignant Schwannoma. 2. Another is 18 years old female who had large bulging mass on right chest wall and pleural effusion in right thoracic cavity. Thoracentesis revealed a large amount of lymphocytes misdiagnosed of Tbc, pleurisy with Neurofibromatosis. We performed tissue biopsy on bulging mass and the specimen was confirmed malignant Schwannoma 2 months after first diagnosis of Tbc. pleurisy. She was not accessible to radical resection because of far advanced malignant Schwannoma at that time. 3. Third case is 28 years old male who was taken enbloc resection of tumor including rib due to Neurofibroma with Neurofibromatosis at M. hospital 6 months ago. But he had rapid growing mass at operation site again and taken tissue biopsy confirmed of malignant Schwannoma. He was not accessible to enbloc resection due to malignant Schwannoma extending to mediastinal structures.

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Multifocal kaposiform hemangioendothelioma of soft tissue with bilateral pulmonary involvement in an adolescent

  • Azma, Roxana;Alavi, Samin;Khoddami, Maliheh;Arzanian, Mohammad Taghi;Nourmohammad, Armin;Esteghamati, Sadaf
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.500-504
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    • 2014
  • Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor of intermediate malignancy with resemblance to Kaposi sarcoma. It occurs predominantly in pediatric age groups as a cutaneous lesion with focal infiltration into the adjacent soft tissue and bone. Although visceral involvement is very uncommon, several cases with bone, retroperitoneal, or mediastinal involvement have been described. KHE has been reported to occasionally occur in unusual sites such as the thymus, tonsils, larynx, paranasal sinuses, deltoid muscle, spleen, uterine cervix, thoracic spine, and even the breast. Multifocal KHE is an extremely rare entity with few reports available in the literature, none of which describes pulmonary involvement. Herein, we report a unique case of multifocal KHE in a 13-year-old boy presenting with a huge soft tissue mass in the upper extremity complicated by bilateral pulmonary nodules that developed into large, necrotic tumor masses.