No abstract available.
Thoracic Surgery, Video-Assisted

Postpneumonectomy empyema is a life-threatening complication, which is often related with a bronchopleural fistula. After surgical repair of fistula, sterilization of infected pleural cavity is important and usually carried out by long-term cyclic irrigation. We report a case in which vacuum-assisted closure device was successfully applied to sterilize the pleural cavity and obliterate bronchopleural fistula.
Bronchial Fistula ; Empyema ; Fistula ; Negative-Pressure Wound Therapy ; Pleural Cavity ; Pneumonectomy ; Sterilization

BACKGROUND: Treatment of pulmonary metastasis from urothelial cell carcinoma has been mostly palliative chemotherapy and the role of pulmonary metastasectomy has not been investigated much. MATERIALS AND METHODS: This study is a retrospective interim review of pulmonary metastasectomy from urothelial carcinoma at single institution between 1998 and 2010. Overall 16 patients underwent pulmonary metastasectomies. RESULTS: There was no postoperative complication or hospital mortality. Mean hospital stay was 6 days. Overall and disease-free 5-year survival were 65.3% and 37.5%, respectively. CONCLUSION: In selected patients with pulmonary metastasis from urothelial carcinoma, surgical treatment is feasible and could contribute to long-term survival in selected patients.
Hospital Mortality ; Humans ; Length of Stay ; Lung Neoplasms ; Metastasectomy ; Neoplasm Metastasis ; Postoperative Complications ; Retrospective Studies

PURPOSE: Cancer gene therapeutic strategy using p53 tumor suppresser gene have been suggested to be effective in many solid tumors including non-small cell lung cancer (NSCLC). To test generalized applicability, we tested a number of non-small cell lung cancer cell lines for their sensitivity to adenoviral-mediated wild-type p53 gene transfer. MATERIALS AND METHOD: Replication-incompetent recombinant adenovirus encoding wild- type p53 (Avp53) under the control of the human cytomegalovirus (CMV) promoter was constructed and the cytotoxic effectiveness was evaluated in various NSCLC cell lines. Because 20 moi (multiplicity of infection; number of active virus particle/cell number) of Avp53 showed highly-effective cytotoxicity in p53-deleted cell lines (NCI-H1299, and NCI-H358), same amount was used for other cell lines. RESULTS: Variable degree of cytotoxicity were observed in cell line with p53 mutation, but almost no effect were observed in those with will-type p53. Neither the infectivity of adenovirus, which was observed by x-gal stain after adenoviral mediated lac Z gene, nor the expression of p53 protein in infected cell, which was observed by western blot, was not the useful marker to expect the cytotoxic effect of Avp53. However, in responsive cell lines with Avp53, prominent expression of p21 protein, which was observed by western blot, was noticed. CONCLUSION: In conclusion, adenoviral-mediated wild-type p53 transfer may not be applicable to every patient with non-small cell lung cancer, especially when the tumor has wild-type p53 gene. Better method to predict the effectiveness before application and strategy to widen the applicable extent is needed.
Adenoviridae ; Blotting, Western ; Carcinoma, Non-Small-Cell Lung* ; Cell Line* ; Cytomegalovirus ; Genes, Neoplasm ; Genes, p53* ; Humans

Primary pulmonary liposarcoma is extremely rare disease. It has poor prognosis with early multiple metastases and frequent local recurrences. Surgery is the choice of treatment for liposarcoma. Incomplete resection would result in rapid and aggressive growing of the tumor. We report a case of primary pulmonary liposarcoma which was successfully treated with complete resection without local recurrence and distant metastasis for 10 months.
Liposarcoma* ; Lung Neoplasms ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Rare Diseases ; Recurrence

Metaplastic thymoma (MT), accepted in the World Health Organization 2004 scheme, is a circumscribed tumor of the thymus exhibiting biphasic morphology. We herein describe the clinicopathologic features of four MTs and the differential diagnoses of this unusual tumor. There were three women and one man with mean age of 49.5 years. The patients were found to have mediastinal masses, and underwent surgical excision. One exhibited symptoms of myasthenia gravis, and the serum titer for anti-acetylcholine receptor antibody was positive. Grossly, the tumors were encapsulated, and showed vaguely multinodular, solid, tan-white to yellow cut surfaces. Histologically, they comprised epithelial islands intertwining with bundles of delicate spindle cells. The patients remained well after surgical excision at 5-55 months. Because of the distinctive histological appearance and benign clinical course, MT should be distinguished from other more aggressive mediastinal neoplasms displaying biphasic feature.
Carcinosarcoma ; Diagnosis, Differential ; Female ; Humans ; Islands ; Mediastinal Neoplasms ; Metaplasia ; Myasthenia Gravis ; Thymoma ; Thymus Gland ; World Health Organization

Primary acinic cell carcinoma (ACC) of the lung is very rare and this tumor is thought to arise from pluripotent cells of the submucosal glands of the tracheobronchial tree. We report here on a case of primary ACC of the lung in a 68-year-old man who had a solitary pulmonary nodule in the left lower lobe. The patient was symptomless and the lesion was found on a chest X-ray taken during a regular health checkup. The video assisted thoracoscopic surgery wedge resection revealed an ovoid yellow tan solid mass that was 1.8 cm at the largest diameter. Microscopically, the neoplastic cells grew in solid sheets of round cells with eccentric nuclei and abundant basophilic granular cytoplasm. There were no mitotic figures or areas of pleomorphic or anaplastic cells. Immunohistochemical staining for cytokeratin (AE1/AE3) was positive, but the staining for chromogranin A and CD56 was negative. Ultrastructural examination revealed polyhedral cells with many zymogen granules of varying electron density. The patient is well 4 months postoperatively.
Acinar Cells ; Aged ; Basophils ; Carcinoma, Acinar Cell ; Chromogranin A ; Cytoplasm ; Electrons ; Humans ; Keratins ; Lung ; Lung Neoplasms ; Secretory Vesicles ; Solitary Pulmonary Nodule ; Thoracic Surgery, Video-Assisted ; Thorax ; Triacetoneamine-N-Oxyl

The aim of the present study was to evaluate the pattern of recurrence after complete resection of pathological stage I, II non-small cell lung cancer, especially according to the cell type. We reviewed the clinical records of 525 patients operated on for pathologic stage I and II lung cancer. The histologic type was found to be squamous in 253 and non-squamous in 229 patients. Median follow-up period was 40 months. Recurrences were identified in 173 (36%) of 482 enrolled patients; distant metastasis in 70%, distant and local recurrence in 11%, and local recurrence in 19%. Distant metastasis was more common in non-squamous than in squamous cell carcinoma (p=0.044). Brain metastasis was more frequently identified in non-squamous mthan in squamous cell carcinoma (24.2% vs. 7.3%. p=0.005). Multivariate analyses showed that cell type is the significant risk factor for recurrence-free survival in stage I and stage II non-small cell lung cancer. Recurrence-free survival curves showed that non-squamous cell carcinoma had similar risks during early periods of follow-up and more risks after 2 yr from the operation compared to squamous cell carcinoma. Pathological stage and histologic type significantly influence recurrence-free survival.
Brain Neoplasms/mortality/secondary ; Carcinoma, Non-Small-Cell Lung/*mortality/*pathology/surgery ; Carcinoma, Squamous Cell/mortality/pathology/surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms/*mortality/*pathology/surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local/mortality/pathology ; Neoplasm Staging/*mortality ; Pneumonectomy ; Risk Factors ; Survival Analysis

Chordomas are slowly growing and rare malignant tumors arising from the remnants of the notochord. Furthermore, intrathoracic chordomas presenting as a posterior mediastinal tumor account for only 1~2% of all reported chordomas. Incomplete resection of these tumors can lead to local recurrence, distant metastasis and result in a poor outcome, but complete remission can be expected with complete resection and adjuvant radiotherapy. We report a case of thoracic chordoma presenting as a posterior mediastinal tumor which was successfully treated with complete resection and adjuvant radiotherapy without recurrence and distant metastasis for 2 years.
Chordoma* ; Mediastinal Neoplasms ; Neoplasm Metastasis ; Notochord ; Radiotherapy, Adjuvant ; Recurrence ; Spinal Neoplasms

Postpneumonectomy syndrome is a rare condition characterized by dyspnea due to an extreme mediastinal shift and bronchial compression of the residual lung after a right pneumonectomy or a left pneumonectomy with the right aortic arch. Severe fibrosis of the lung such as tuberculsosis (TB) - destroyed lung can cause similar clinical features in the absence of pneumonectomy. We report a unique case of postpneumonectomy syndrome without pneumonectomy, which was successfully treated with pneumonectomy and mediastinal repositioning with tissue expanders.
Aorta, Thoracic ; Dyspnea ; Fibrosis ; Lung* ; Pneumonectomy ; Tissue Expansion Devices ; Tuberculosis, Pulmonary