ABSTRACT
Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.
Subject(s)
Adult , Humans , Male , Abdominal Injuries , Asymptomatic Diseases , Spleen , Wounds and Injuries , Splenectomy , Splenosis , Diagnosis , Pathology , General Surgery , Thoracic Diseases , Diagnosis , Pathology , General Surgery , Thoracic Injuries , Thoracotomy , Unnecessary ProceduresABSTRACT
Objective To describe the effects of surgical intervention on the prognosis in non-small-cell lung cancer patients with pleural carcinomatosis detected at thoracotomy.Methods Retrospectively analyzed clinical data from 54 patients who have unexpected malignant pleural nodules and/or malignant pleural effusions first detected at thoracotomy from January 2009 and December 2013.The effects of surgical intervention on the prognosis were also discussed.Results Sixteen cases had only biopsy,whereas 38 (70.4％) cases had primary tumor resection.The median survival time of 54 patients with pleural carcinomatosis were 23 months.The overall 1 and 5-year survival rates were 64％ and 18％,respectively.Primary tumor resection had significantly better outcome compared with biopsy(MST:respectively,24 vs 15 months,5-year survival rate 39％ vs 6％,P ＜0.05).Univariate analysis showed that primary tumor resection,no smoking history,lower T and N stage has favorable survival(P ＜ 0.05).Multivariate analysis showed that the best N stage(P =0.002) and adenocarcinoma(P =0.035) were favorable prognostic factors in these patients.Conclusion For patients with pleural careinomatosis first detected at thoracotomy,limited primary tumor resection may have survival benefits,lower T and N stage for them was associated with better survival.
ABSTRACT
Objective To describe the effects of surgical intervention on the prognosis in non-small-cell lung cancer patients with pleural carcinomatosis detected at thoracotomy.Methods Retrospectively analyzed clinical data from 54 patients who have unexpected malignant pleural nodules and/or malignant pleural effusions first detected at thoracotomy from January 2009 and December 2013.The effects of surgical intervention on the prognosis were also discussed.Results Sixteen cases had only biopsy,whereas 38 (70.4％) cases had primary tumor resection.The median survival time of 54 patients with pleural carcinomatosis were 23 months.The overall 1 and 5-year survival rates were 64％ and 18％,respectively.Primary tumor resection had significantly better outcome compared with biopsy(MST:respectively,24 vs 15 months,5-year survival rate 39％ vs 6％,P ＜0.05).Univariate analysis showed that primary tumor resection,no smoking history,lower T and N stage has favorable survival(P ＜ 0.05).Multivariate analysis showed that the best N stage(P =0.002) and adenocarcinoma(P =0.035) were favorable prognostic factors in these patients.Conclusion For patients with pleural careinomatosis first detected at thoracotomy,limited primary tumor resection may have survival benefits,lower T and N stage for them was associated with better survival.