Giant mature teratoma in thymic tissue removed with uniportal vats approach

Unusual presentation of giant mature mediastinal teratoma in a young child: A case report

Mature mediastinal teratoma is a rare benign tumor in children. Few cases have been reported in the literature. Moreover, this tumor is often characterized by slow growth, reaching a large volume and frequently causing nonspecific symptoms, making its diagnosis more difficult. It raises the question of differential diagnosis with malignant mediastinal tumors in pediatric patients, requiring histological confirmation by biopsy or excision. The purpose of this article is to report an atypical clinical finding characterized by spinal deformity, and to contribute to medical knowledge concerning this uncommon pediatric tumor.

Non-Lobe Specific Metastases in Occult N2 after Lobectomy for Clinical N0 Non-Small Cell Lung Cancer

OBJECTIVES

Non-small cell lung cancer can spread into lobe specific stations and non-lobe-specific mediastinal lymph nodes. We evaluated frequency and features of non-lobe specific nodal metastases, focusing especially on the prognostic value of only non-lobe specific N2-metastases after lobectomy.

METHODS

We performed a retrospective review of 550 patients with non-small cell lung cancer with clinical N0, undergoing lobectomy and systematic or lobe specific node dissection. We evaluated disease free and overall survival rates using Kaplan-Meier method and significance was tested by log-rank test.

RESULT

Occult N2 disease was detected in 68 patients (8.1%), 26 of them (38.2%) had metastases in non-lobe specific stations. Comparing patients with lobe and non-lobe specific lymph node metastases, 3-years DFS rate was 44.4% vs. 20.0% (p-value = 0.009), while 3-years OS rate was 87.3% vs. 26.7% (p-value <0.001). Among patients with non-lobe specific metastases 16 of them (61.5%) had only non-lobe specific metastases, the remaining 10 patients (38.5%) had metastatic lymph node at the same time in non-lobe specific station but also in lobe-specific stations. Comparing post-operative survival between patients with only non-lobe specific metastases and synchronous lobe and non-lobe specific metastases, 3-years DFS rate was 12.5% vs. 41.3% respectively (p-value = 0.03), and 3-years OS rate was 12.5% vs 76.7% (p-value = 0.002).

CONCLUSION

In patients with occult N2 disease, the finding of a metastatic lymph node in a non-lobe specific station relates with significant lower survival rate. The subset of patients who presented only non-lobe specific node metastases showed a significant lower survival rate compared to the remaining occult N2.