ABSTRACT
BACKGROUND: Radiotherapy associated with chemotherapy is a well-established treatment modality for locally advanced non-small cell lung cancers. Radiation-induced second malignancies, particularly radiation-induced sarcomas, are rare. Some authors reported a recent increase in the incidence of this rare complication, especially because of the improved prognosis and survival of patients after radiotherapy. Pathogenic mechanisms of radiation-induced sarcomas are poorly understood. However, diagnosis criteria are well established. Treatment options must be discussed and adapted to the patient's profile. Surgery in irradiated tissue is challenging, with limited treatment options with chemotherapy and radiotherapy. CASE PRESENTATION: We report the case of a 62-year-old Moroccan man diagnosed as having chondrosarcoma of his right scapula, who was irradiated 10 years ago for stage IIIB non-small cell lung cancer. This case was managed by a complete resection of the tumor with good functional and oncological outcomes. To the best of our knowledge, the scapular location of radiation-induced sarcoma after irradiation for lung cancer has never been described in the literature. CONCLUSION: Radiation-induced sarcoma of the scapula represents a rare situation that must be actively researched to have access to an optimal therapeutic approach.
Subject(s)
Bone Neoplasms , Carcinoma, Non-Small-Cell Lung/radiotherapy , Chondrosarcoma , Lung Neoplasms/radiotherapy , Neoplasms, Radiation-Induced , Scapula , Bone Neoplasms/pathology , Bone Neoplasms/surgery , Carcinoma, Non-Small-Cell Lung/pathology , Chondrosarcoma/pathology , Chondrosarcoma/surgery , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasms, Radiation-Induced/pathology , Radionuclide Imaging , Radiotherapy Dosage , Scapula/pathology , Scapula/radiation effects , Scapula/surgery , Treatment OutcomeABSTRACT
Leiomyoma is a benign smooth muscle tumor usually encountered in the uterus. Primary pulmonary localization is extremely rare in adults and children. However, it must be included in the differential diagnosis of any nodular lung lesion. Its treatment is surgical, with good long-term results. Here, we report a case of leiomyoma of lung parenchyma diagnosed in a 26-year-old man.
Subject(s)
Leiomyoma , Lung Neoplasms , Adult , Biopsy , Humans , Leiomyoma/diagnostic imaging , Leiomyoma/pathology , Leiomyoma/surgery , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Magnetic Resonance Imaging , Male , Pneumonectomy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Lipoma is a common benign tumor of soft tissues in adults. An intrathoracic location, particularly in the parietal pleura, is rare. We report two cases of pleural parietal lipoma with a review of literature. A preoperative diagnosis was established histologically by fine-needle aspiration in the first case and radiologically by computed tomography scan in the second. Both patients underwent surgical excision via thoracotomy and video-assisted thoracic surgery. Pathology examination confirmed the diagnosis of lipoma. The authors emphasize the necessity of surgical resection because of preoperative diagnostic difficulty of discerning lipoma from well-differentiated liposarcoma.
Subject(s)
Lipoma , Pleural Neoplasms , Adult , Biopsy, Fine-Needle , Diagnosis, Differential , Humans , Lipoma/diagnosis , Lipoma/surgery , Liposarcoma/diagnosis , Male , Middle Aged , Pleura/diagnostic imaging , Pleura/pathology , Pleural Neoplasms/diagnosis , Pleural Neoplasms/surgery , Predictive Value of Tests , Thoracic Surgery, Video-Assisted , Thoracotomy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
BACKGROUND: The objective of this study was to report our experience in the management of hydatid cysts of the mediastinum. METHODS: Among 206 patients who underwent surgery in our department for intrathoracic hydatid cysts between September 2001 and September 2008, 7 patients (3.4%) aged 24 to 49 years (mean, 36.2 years) had mediastinal hydatid cysts. Imaging consisted of chest X-ray and computed tomography. Surgical approach was by posterolateral thoracotomy in all cases. RESULTS: The cyst was located in the posterior mediastinum in 3 cases (42.8%), in the anterior mediastinum in 2 cases (28.5%) and in the middle mediastinum in 2 cases (28.5%). Two patients had cysts in other thoracic locations (diaphragm, pleural). All cysts were intact. Surgical approach was right thoracotomy in 5 patients (71.4%) and left thoracotomy in 2 patients (28.5%). In 5 cases, a small part of the cyst wall intimately adherent to vital structures was left in place. There were no postoperative complications or mortality. CONCLUSION: Mediastinal hydatid cyst is an uncommon disease. Because of the surrounding vital structures, the cyst should be removed immediately. Surgical removal remains the treatment of choice for mediastinal echinococcosis, without extensive resection when progression of dissection is impossible or dangerous.
Subject(s)
Echinococcosis/diagnosis , Mediastinal Cyst/diagnosis , Adult , Echinococcosis/surgery , Female , Humans , Male , Mediastinal Cyst/parasitology , Mediastinal Cyst/surgery , Middle Aged , Radiography, Thoracic , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Hydatid cystic disease is still a health problem in Morocco. Mediastinal localization is very rare. We report the case of a 24-year-old man who presented with right chest pain and dyspnea. Chest X-Ray and computed tomography showed a mediastinal mass. The diagnosis was confirmed perioperatively by macroscopic and histologic investigations. Resection of the cyst was performed, and a small part intimately adherent to the inferior vena cava and oesophagus was left in place. There were no complications or recurrence.
