Survival analysis of Thai patients with non-small-cell lung cancer undergoing surgical resection.

This study examined the survival duration among patients with non-small-cell lung cancer (NSCLC) undergoing surgical resection from January 1988 to December 1992 at the Central Chest Hospital, Thailand. Patients were followed-up until death or survival as of September 1997. Survival durations for different stages were analysed by Kaplan-Meier analysis and log rank test. A total of 127 patients with histologically proved NSCLC underwent 79 lobectomies, 9 bilobectomies, 39 pneumonectomies during 1988-1992. The mean age was 60 years (SD 10.4). There were 103 males and 24 females. Percentage of histologic types were: 59 per cent adenoCA, 35 per cent squamous cell CA, and 6 per cent large cellCA. Survival analysis was feasible in 88 patients, 38 alive and 50 deaths. 1-yr, 2-yr, and 5-yr survival were as following: 85 per cent, 78 per cent, and 60 per cent in stage 1 (n = 47); 70 per cent, 50 per cent, and 30 per cent in stage 2 (n = 12); and 54 per cent, 23 per cent, and 15 per cent in stage 3a (n = 29) [log rank 19.06, df 2, p = 0.0001]. Based on the present study, the survival outcome in patients with lung cancer beyond stage 1 is uniformly poor. Measures should be made to diagnose early stage disease and expedite surgery in order that a better survival outcome can be achieved.

Intrapulmonary teratoma: a report of three cases.

Three cases of intrapulmonary teratoma are described. A specific symptom of trichoptysis occurred in two patients. The other presented with only recurrent hemoptysis. All were treated by lobectomy of the affected lung. Pathologic examination in each specimen showed that the tumor had a cystic portion which was connected to the bronchial system and contained sebaceous material and pieces of hair. The solid portion consisted of tissues representing all three germ cell layers. The pathologic findings correlated well with the clinical symptoms and radiologic findings in the patients.

Primary tumors of the mediastinum: 190 cases analysis (1975-1995).

A series of 190 patients with primary mediastinal tumors have been reviewed, typing of the tumors is according to pathological findings. The most common type of primary mediastinal tumors in this study was tumors of germ cell origin which comprised 38.9 per cent of total cases. Most patients were adults with a median age of 33.1 years and male to female ratio was 1.24:1. The characteristic of each type of tumor has been discussed. The common presenting symptoms were dyspnea, chest pain, and coughing, hemoptysis may occur in some cases. Only 7.9 per cent of cases were asymptomatic and all were discovered during the so-called "routine" chest X-ray examination. The diagnosis can be reached by the radiographic finding of mediastinal shadows. Bronchoscopy is commonly valuable to confirm external compression of the trachea and bronchi as well as revealing the invasion of the mediastinal tumors into the bronchial lumen. Pathological findings of the tissue sections obtained from fine needle aspiration or biopsy, as well as surgical specimen can provide the definite diagnosis and classification of the tumors. The benign tumors were successfully removed by surgery. As some types of malignant tumors are either chemosensitive or radiosensitive; chemotherapy and/or radiotherapy carries a potential survival benefit and should be incorporated into the multimodality approach to prolong disease-free survival.

Pleomorphic lipoma in the middle mediastinum.

Mediastinal pleomorphic lipoma was found in a 63-year-old Thai male who presented with problems of chronic cough, dyspnea and dysphagia for 1 year. CT and MRI studies revealed a well-circumscribed mass in the middle mediastinum. Thoracotomy was performed and excision of the tumor was done completely. The pathological features of the tumor were typical of pleomorphic lipoma. While lipomas are common tumors in the mediastinum, liposarcomas are rare and there has been no reported case of mediastinal pleomorphic lipoma before. Differential diagnosis of liposarcoma was very important in this case due to different clinical courses and prognoses.

Pulmonary hydatid cyst in Thai: A report of first case.

The first case of Pulmonary Hydatid Cyst at the Central Chest Hospital was recently found in a Thai male presenting with haemoptysis. His chest x-ray revealed a round mass (2.5x3.5 cm) with distinct border at the anterior segment of the left upper lobe. The diagnosis of lung cyst was made by ultrasonography. Examination of aspirated cyst fluid revealed Echinococcus granulosus parasite. Left thoracotomy was performed to remove the cyst; there was no post-operative complication.