RESUMO
Solitary fibrous tumor (SFT) of the pleura and the lung is an uncommon spindle cell neoplasm arising from the visceral pleura in the majority of the cases. However there are some extrapleural sites including the lung. Current considerations were raised by a peculiar recent case: an 81-year-old female, no smoker, presented with undefined left thoracic pain. Radiographic findings of a large solid lung mass (10 cm × 9 cm). Computed tomography (CT) confirmed the thoracic mass showing characteristics of a well defined mass with capsule, the position of the mass in proximity of the postero-basal and lateral-basal wall. No secondary lesions were found. Through a left inferior lobectomy and ilo-mediastinal lymph node sampling, the entire mass was resected. Histopathological examination revealed a SFT. In conclusion STF is a rare lesion and this case showed a peculiar extremely large lesion never described before in literature.
RESUMO
OBJECTIVES: One of the fundamental steps in an anatomical pulmonary resection is the main and lobar bronchus suture. Nowadays, two different types of staplers are on the market: the linear TA stapler for open surgery (Tyco Healthcare Group LP, Norwalk, CT, USA), which is based on a 'guillotine' mechanism, sewing, but not cutting the bronchus, and the endoscopic linear stapler which both cuts and sews. This study aimed to fill the void in the use of an instrument used to staple and cut at the same time in 'open' thoracic surgery, eliminating the need for a scalpel: the curved cutter stapler (Contour Curved Cutter Stapler; Ethicon Endo-Surgery, Inc., Cincinnati, OH, USA). METHODS: Between May 2009 and March 2011, the Contour Curved Stapler (Ethicon) was used for the bronchus in 139 cases of non-small cell lung carcinoma (NSCLC)-29 females and 110 males ranging between 48 and 85 years (average 71.1)-and comprising 115 lobectomies (8 bilobectomies) and 24 pneumonectomies (8 on the right lung, 16 on the left lung). RESULTS: All patients underwent a bronchoscopic check-up 30 days after they were discharged: in all cases, the bronchial stump was clearly within normal limits. No cases of bronchopleural fistulas were observed in the 139 patients. CONCLUSIONS: On the basis of this study, the curved cutter stapler showed to be a satisfactory device for securing the bronchus during an anatomic resection (whether lobar or main), in 'open' thoracic surgery. However, even though there were no cases of fistula, we consider that our data is still too limited to be statistically significant.