Conservative treatment of a posterior intercostal lung herniation: a case report.

Introduction patients: A rare posterior intercostal lung herniation was diagnosed after a coughing spell by computed tomography and treated conservatively. Two years later, there were no specific complications or progression of the herniation. Methods, results and conclusions: There is no consensus on the indications for surgery and optimal treatment of this disorder.

An intradural, subpial lipoma.

Introduction - patients: Intradural lipomas are rare congenital tumors. A case of intradural lipoma in the absence of any congenital spinal anomalies is reported. Patient presented with spinal cord compression syndrome. Methods - results - conclusions: Treatment of this disorder is still controversial.

Unclassifiable B-cell lymphoma occurring after necrotizing pneumonia.

We report a case of CD20+ grey zone lymphoma (GZL) with Reed Sternberg cells as an unexpected pathological diagnosis of a destroyed right lower lobe after necrotizing pneumonia. These GZLs show overlapping features of classical Hodgkin's lymphoma and diffuse large B-cell lymphoma. GZLs are a rare specific entity of lymphomas, and the aetiology is unknown. The diagnosis is confirmed by pathological, immunohistochemical and molecular analyses. The optimal treatment is unknown. The prognosis of these patients is poor.

Quality of life evolution after pulmonary metastasectomy: a prospective study comparing isolated lung perfusion with standard metastasectomy.

OBJECTIVE: To prospectively evaluate quality of life (QoL) evolution after a classic pulmonary metastasectomy or after an isolated lung perfusion (ILuP) metastasectomy. METHODS: QoL was prospectively recorded in 35 consecutive patients (27 classic metastasectomy; 8 ILuP) The European Organisation for Research and Treatment of Cancer C30 and lung cancer -13 QoL Questionnaires were administered before surgery and 1, 3, 6 and 12 months postoperatively (MPO). RESULTS: After a classic metastasectomy, a temporary increase in dyspnea (1 MPO p = 0.03 3 MPO p = 0.01), coughing (3 MPO p = 0.01), fatigue (1 MPO p = 0.01, 3 MPO p = 0.02), thoracic pain (1 MPO, p = 0.02), shoulder dysfunction (1 MPO p = 0.03, 3 MPO p = 0.02) as well as an impaired physical (1 MPO p = 0.01, 3 MPO p = 0.04) and role functioning (1 MPO p = 0.01, 3 MPO p = 0.01) was reported the first 3 months after surgery. Six months after surgery, all domains returned to baseline. After ILuP metastasectomy, all QoL functioning and symptom scores, except for coughing complaints (1 MPO p = 0.03, 3 MPO p = 0.04) and shoulder dysfunction (1 MPO p = 0.04, 6 MPO p = 0.04), returned to baseline at 1 month after surgery. No significant differences were seen when QoL evolution was compared between classic and ILuP metastasectomy with the exception of a higher burden of thoracic pain (6 MPO p = 0.04, 12 MPO p = 0.01), shoulder dysfunction (6 MPO p = 0.04, 12 MPO p = 0.02), and dysphagia (6 MPO p = 0.04, 12 MPO p = 0.02) 6 and12 months after ILuP. CONCLUSIONS: All QoL domains returned to baseline at 6 months after a classic metastasectomy. After ILuP, only increases in coughing and shoulder dysfunction were reported. In comparison classic metastasectomy patients, ILuP patients report more thoracic pain, shoulder dysfunction, and dysphagia.

Debulking of stage IVA thymoma.

We present a debulking procedure for the removal of a stage IVA thymoma in a patient with myasthenia gravis (MG). This included thymectomy to remove the primary thymoma, resection of an anterior paracardial mass, a posterior pleural mass, partial pleurectomy, resection of phrenic nerve and wedge excisions of the right upper, middle and lower lobes.

The effect of smoking cessation on quality of life after lung cancer surgery.

OBJECTIVE: This study aimed to evaluate the effect of smoking status on quality of life (QoL) after non-small-cell lung cancer surgery with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and LC13. METHODS: QoL was prospectively recorded in 70 consecutive patients undergoing lobectomy or pneumonectomy. Questionnaires were administered preoperatively and 1, 3, 6 and 12 months postoperatively (MPO). RESULTS: Of all patients analysed, nine (13%) were non-smokers, 20 (29%) former smokers, six (8%) recent quitters and 35 (50%) current smokers. All four groups had comparable patients' characteristics and preoperative QoL scores, with exception of non-smokers who had significantly lower physical functioning, role functioning, cognitive functioning and a higher thoracic pain burden. In non-smokers, all QoL scores returned to baseline 3 months after surgery. Former smokers complained of a significant 3-month decrease in physical functioning (3 MPO, p = 0.01) and a 12-month decrease in role functioning (12 MPO, p = 0.01). Former smokers complained of a significant increase in dyspnoea (6 MPO, p = 0.001) during the first 6 months after surgery. Recent quitters had a longer impairment in physical functioning (6 MPO, p = 0.01) and a 3-month burden of dyspnoea (3 MPO, p=0.02). In current smokers, no return to baseline in physical (12 MPO, p = 0.01), role (12 MPO, p = 0.01) and social functioning (12 MPO, p = 0.02) and a persistent increase in dyspnoea (12 MPO, p = 0.04) were reported. Current smokers also complained of increased thoracic pain (12 MPO, p = 0.02). Except non-smokers, all patients complained of fatigue the first 3 months after surgery. CONCLUSIONS: Smoking cessation is beneficial at any time point to lung cancer surgery and current smoking at the time of surgery is associated with a poor postoperative QoL.