Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.
Adult ; Choriocarcinoma* ; Chorionic Gonadotropin ; Consolidation Chemotherapy ; Diagnosis, Differential ; Drug Therapy ; Early Diagnosis ; Female ; Fertility ; Follow-Up Studies ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Lung ; Neoplasm Metastasis* ; Pneumothorax* ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts ; Uterus

Lobectomy with mediastinal node dissection has been standard treatment for non-small cell lung cancer (NSCLC). Nowadays, video-assisted thoracoscopic surgery (VATS) is gaining acceptance as an alternative treatment option, given the quality-of-life benefits that it confers. For the VATS procedure, most surgeons create two or three ports with a utility incision of 3 to 5 cm. However, with acquired skill and instrumentation advances, single-incision thoracoscopic surgery has emerged over time. Here, we report the case of an 86-year-old female with NSCLC treated by single-incision segmentectomy.
Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung* ; Female ; Humans ; Lung Neoplasms ; Mastectomy, Segmental* ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery, Video-Assisted ; Thoracoscopy

We report a very rare case of surgery on gastric conduit cancer. A 67-year-old male patient underwent esophagectomy and intrathoracic esophagogastrostomy for squamous cell carcinoma of the lower thoracic esophagus 27 months ago. Upon follow-up, a gastric carcinoma at the intra-abdominal part of the gastric conduit was found on an esophagogastroduodenoscopy. We performed total gastrectomy and esophagocolonojejunostomy in the manner of Roux-en-Y anastomosis. The postoperative course was not eventful and an esophagogram on the 10th postoperative day showed no leakage or stenosis of the passage. The patient was discharged on the 17th day with no complications.
Aged ; Anastomosis, Roux-en-Y ; Carcinoma, Squamous Cell ; Constriction, Pathologic ; Endoscopy, Digestive System ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Follow-Up Studies ; Gastrectomy ; Humans ; Male

BACKGROUND: The aim of the present study was to identify chromosomal loci that contribute to the pathogenesis of aortic dissection (AD) in a Korean population using array comparative genomic hybridization (CGH) and to confirm the results using real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: Eighteen patients with ADs were enrolled in this study. Genomic DNA was extracted from individual blood samples, and array CGH analyses were performed. Four corresponding genes with obvious genomic changes were analyzed using real-time PCR in order to assess the level of genomic imbalance identified by array CGH. RESULTS: Genomic gains were most frequently detected at 8q24.3 (56%), followed by regions 7q35, 11q12.2, and 15q25.2 (50%). Genomic losses were most frequently observed at 4q35.2 (56%). Real-time PCR confirmed the results of the array CGH studies of the COL6A2, DGCR14, PCSK6, and SDHA genes. CONCLUSION: This is the first study to identify candidate regions by array CGH in patients with ADs. The identification of genes that may predispose an individual to AD may lead to a better understanding of the mechanism of AD formation. Further multicenter studies comparing cohorts of patients of different ethnicities are warranted.
Aorta ; Cohort Studies ; Comparative Genomic Hybridization ; DNA ; Humans ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction

PURPOSE: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation. MATERIALS AND METHODS: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy). RESULTS: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively. CONCLUSION: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.
Arm ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Consolidation Chemotherapy ; Follow-Up Studies ; Humans ; Joints ; Multivariate Analysis ; Paclitaxel ; Survival Rate

PURPOSE: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation. MATERIALS AND METHODS: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy). RESULTS: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively. CONCLUSION: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.
Arm ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Consolidation Chemotherapy ; Follow-Up Studies ; Humans ; Joints ; Multivariate Analysis ; Paclitaxel ; Survival Rate

Sarcoidosis is a somewhat common pulmonary disease, but the concurrence of lung cancer and sarcoidosis in the same patient is very rare. Because sarcoidosis usually presents as mediastinal lymphadenopathies, this concurrence in a lung cancer patient detected radiologically is apt to be misunderstood to be mediastinal metastases, and it is thus considered to be an unresectable disease. We report a case of lung cancer associated with sarcoidosis that developed in a 65-year-old woman who underwent surgery. Radiological studies revealed a 1.9x1.7 cm mass in the left upper lobe with multiple enlarged bilateral mediastinal lymph nodes (2R, 3a, 4R, 4L, 5, 6, 7, 8R). Pathologic findings showed that the mass was a well-differentiated adenocarcinoma and all of the enlarged mediastinal lymph nodes were granulomas without cancer metastasis. We report this case with a review of the literature.
Adenocarcinoma ; Aged ; Dimaprit ; Female ; Granuloma ; Humans ; Lung ; Lung Diseases ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Sarcoidosis

Sarcoidosis is a somewhat common pulmonary disease, but the concurrence of lung cancer and sarcoidosis in the same patient is very rare. Because sarcoidosis usually presents as mediastinal lymphadenopathies, this concurrence in a lung cancer patient detected radiologically is apt to be misunderstood to be mediastinal metastases, and it is thus considered to be an unresectable disease. We report a case of lung cancer associated with sarcoidosis that developed in a 65-year-old woman who underwent surgery. Radiological studies revealed a 1.9x1.7 cm mass in the left upper lobe with multiple enlarged bilateral mediastinal lymph nodes (2R, 3a, 4R, 4L, 5, 6, 7, 8R). Pathologic findings showed that the mass was a well-differentiated adenocarcinoma and all of the enlarged mediastinal lymph nodes were granulomas without cancer metastasis. We report this case with a review of the literature.
Adenocarcinoma ; Aged ; Dimaprit ; Female ; Granuloma ; Humans ; Lung ; Lung Diseases ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Sarcoidosis

No abstract available.

PURPOSE: This study aimed to analyze the efficacy and toxicity of gemcitabine plus platinum chemotherapy for patients aged 70 years or older with advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: We reviewed the records of stage IIIB, IV NSCLC patients or surgically inoperable stage II, IIIA NSCLC patients who were aged 70 years or older when treated with gemcitabine (1,250 mg/m2) plus cisplatin (75 mg/m2) or carboplatin (AUC5) chemotherapy from 2001 to 2010 at Seoul St. Mary's Hospital, Uijeongbu St. Mary's Hospital and St. Vincent's Hospital. Gemcitabine was administered on days 1 and 8, and cisplatin or carboplatin was administered on day 1. Treatments were repeated every 3 weeks for a maximum of 4 cycles. RESULTS: The median age of the 62 patients was 73.5 years (range, 70 to 84 years). Forty-one (66%) patients exhibited comorbidity. The mean number of treatment cycles was 3.9. The compared average relative dose intensity of gemcitabine plus platinum chemotherapy was 84.8%. The median progression-free survival and overall survival (OS) were 5.0 months and 9.4 months, respectively. Reduced Eastern Cooperative Oncology Group (ECOG) performance status (none vs. > or =1) and weight loss (<5% vs. > or =5%) after treatment were found to have a significant effect on OS (p=0.01). CONCLUSION: Gemcitabine plus platinum chemotherapy is an effective treatment option with an acceptable level of toxicity in patients aged 70 years or older with good performance status in advanced NSCLC.
Aged ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Comorbidity ; Deoxycytidine ; Disease-Free Survival ; Drug Therapy, Combination ; Humans ; Lung ; Lung Neoplasms ; Platinum ; Retrospective Studies ; Weight Loss