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Khalid K, Khan A, Lomiguen CM, Chin J. Clinical Detection of Primary Pulmonary Angiosarcoma. Cureus 2021; 13:e17059. [PMID: 34522537 PMCID: PMC8428157 DOI: 10.7759/cureus.17059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/10/2021] [Indexed: 12/01/2022] Open
Abstract
Pulmonary angiosarcomas (PAS) are rare malignant vascular tumors that due to their aggressive and metastatic nature, are often diagnosed at a late stage, resulting in a poorer prognosis. Here we present a 53-year-old male who was initially found to have recurring episodes of dyspnea and syncope, with initial workup showing bilateral saddle pulmonary embolisms on computerized tomography, presumed secondary to newly discovered atrial fibrillation with sinus node dysfunction. Further investigation over subsequent months and subsequent biopsy of a potential lung mass ultimately revealed pulmonary angiosarcoma of the spindle cell line. This case emphasizes findings in the current literature, which reveal the time between the onset of symptoms and definitive diagnosis ranges from two to six months, with a median survival time of seven months or two months, with solitary lesions or multiple lesions at the time of diagnosis, respectively. With the limited incidence of PAS, this case suggests benefits in the development of screening and detection criteria for earlier detection and treatment.
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Affiliation(s)
- Kaynat Khalid
- Department of Primary Care, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Anas Khan
- Department of Primary Care, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Christine M Lomiguen
- Department of Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.,Department of Family Medicine, Millcreek Community Hospital, Erie, USA
| | - Justin Chin
- Department of Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.,Department of Family Medicine, LifeLong Medical Care, Richmond, USA
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2
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Camus B, Cottereau AS, Palmieri LJ, Dermine S, Tenenbaum F, Brezault C, Coriat R. Indications of Peptide Receptor Radionuclide Therapy (PRRT) in Gastroenteropancreatic and Pulmonary Neuroendocrine Tumors: An Updated Review. J Clin Med 2021; 10:1267. [PMID: 33803817 DOI: 10.3390/jcm10061267] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 12/14/2022] Open
Abstract
Radionuclide therapy for neuroendocrine tumors is a form of systemic radiotherapy that allows the administration of targeted radionuclides into tumor cells that express a large quantity of somatostatin receptors. The two most commonly used radio-peptides for radionuclide therapy in neuroendocrine tumors are 90Y-DOTATOC and 177Lu-DOTATATE. Radio-peptides have been used for several years in the treatment of advanced neuroendocrine tumors. Recently, the randomized Phase III study NETTER-1 compared177Lu-DOTATATE versus high-dose (double-dose) octreotide LAR in patients with metastatic midgut neuroendocrine tumors, and demonstrated its efficacy in this setting. Strong signals in favor of efficiency seem to exist for other tumors, in particular for pancreatic and pulmonary neuroendocrine tumors. This focus on radionuclide therapy in gastroenteropancreatic and pulmonary neuroendocrine tumors addresses the treatment modalities, the validated and potential indications, and the safety of the therapy.
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Komatsu M, Sakai Y, Nishikubo M, Tane S, Nishio W, Kajimoto K, Hirose T. EWSR1-CREM fusion in pulmonary mesenchymal neoplasm showing distinctive clear cell morphology. Pathol Int 2020; 70:1020-1026. [PMID: 33002291 DOI: 10.1111/pin.13030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
EWSR1-CREM gene fusions were recently discovered in several mesenchymal and epithelial tumors, including myxoid mesenchymal tumors of the central nervous system, rare cases of soft tissue clear cell sarcoma and angiomatoid fibrous histiocytoma, and hyalinizing clear cell carcinoma, which implicates the potential phenotypic diversities of tumors harboring an EWSR1-CREM fusion. We herein present an exceedingly indolent pulmonary mesenchymal tumor showing distinctive clinicopathological features. This tumor histologically displayed a small nest and alveolar pattern consisting of monomorphic clear cells intermingled with dilated anastomosing vasculature. Immunophenotypically, tumor cells were positive for vimentin and focally positive for synaptophysin, but negative for many immunohistochemical panels including keratins, EMA, desmin, mesothelial markers, melanotic markers, smooth muscle actin, inhibin and S-100 protein. Interestingly, RNA sequencing identified an in-frame EWSR1-CREM fusion, which was confirmed by subsequent real-time/reverse transcription polymerase chain reaction and fluorescence in situ hybridization assay. Clinical follow-up showed no evidence of recurrence and metastasis. Our pathological findings further expand the phenotypic spectrum of tumors associated with EWSR1-CREM fusions, implying the emergence of a possible novel tumor entity.
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Affiliation(s)
- Masato Komatsu
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Hyogo, Japan.,Department of Diagnostic Pathology, Hyogo Cancer Center, Hyogo, Japan
| | - Yasuhiro Sakai
- Department of Diagnostic Pathology, Hyogo Cancer Center, Hyogo, Japan.,Department of Diagnostic Pathology, Kansai Medical University Medical Center, Osaka, Japan
| | - Megumi Nishikubo
- Department of Thoracic Surgery, Hyogo Cancer Center, Hyogo, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Hyogo, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Hyogo, Japan
| | | | - Takanori Hirose
- Department of Diagnostic Pathology, Hyogo Cancer Center, Hyogo, Japan.,Division of Pathology for Regional Communication, Kobe University School of Medicine, Hyogo, Japan
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4
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Liu J, Huang W, Wu Z, Wang Z, Ding X. The application of computed tomography-guided percutaneous coaxial biopsy combined with microwave ablation for pulmonary tumors. J Cancer Res Ther 2020; 15:760-765. [PMID: 31436229 DOI: 10.4103/jcrt.jcrt_778_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The aim of the study is to evaluate the technique, safety, efficacy, and clinical value of computed tomography (CT)-guided percutaneous coaxial biopsy combined with microwave ablation (MWA) therapy for pulmonary tumors. Materials and Methods CT-guided percutaneous coaxial biopsy combined with MWA was performed on 27 tumors in 23 patients who received treatment at our hospital from August 2014 to November 2017. The patients were followed up from 2 to 42 months. The outcomes were evaluated with plain and contrast spiral CT scans. Results After treatment, lower density and lower CT values than baseline values were observed in the ablated area. The positive rate of biopsy was 81.48%. Seventeen patients had complete remission, four had partial remission, and two had progressive disease, with an effective rate of 91.3%. Until February 2018, 14 patients survived. Seven patients with metastatic lung cancer died of primary tumor progression. Two patients with primary lung cancer also died; one died of a lung infection and the other of cerebral hemorrhage. The 1-year local control rate was 88.9%, and the median progression-free survival was 33 months. The 1-, 2-, and 3-year survival rates were 91.3%, 69.6%, and 60.9%, respectively. Conclusion CT-guided percutaneous coaxial biopsy combined with MWA can improve the quality of life of patients, prolong survival, and improve the survival rate. It is currently one of the most promising interventional treatments.
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Affiliation(s)
- Jingjing Liu
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Huang
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyuan Wu
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongmin Wang
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyi Ding
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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5
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Nishizawa N, Hanagiri T, Oyama R, Ashikari S. [Two Resected Cases of Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma, Differently Diagnosed in Chest Tomography Scan]. J UOEH 2019; 41:225-30. [PMID: 31292368 DOI: 10.7888/juoeh.41.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Case 1: A 81-year-old man was admitted to our hospital because of a mass shadow on chest x-ray examination. Chest computed tomography (CT) showed a 1.5 cm nodule in the middle lobe of the right lung. We suspected a primary lung cancer and performed video-assisted right middle lobectomy. Histopathological examination showed a white, elastic, hard and solid 30 × 10 × 10 mm nodule with infiltration of small-to-medium-sized lymphocytes that were positive for CD20 and CD79a, and negative for CD10 and Cyclin D1 in immunohistochemical staining. We diagnosed mucosa-associated lymphoid tissue (MALT) lymphoma. Case 2: A 67-year-old woman was admitted to our hospital because of a mass shadow in the right upper lobe on chest x-ray and chest CT. As the lesion had not grow in 1 year, the patient strongly wanted it resected, therefore we performed wedge resetion of the right upper lobe via video-assisted thoracic surgery. Histopathological examination showed a white, elastic, hard and solid 25 × 25 × 16 mm nodule with infiltration of small-to-medium-sized lymphocytes that had positive staining of CD20 and CD79a, and negative staining of CD10 and Cyclin D1. We diagnosed MALT lymphoma. Primary lung MALT lymphoma shows a variety of shadows on chest CT, similar to lung cancer and other inflammatory diseases. Local therapies such as surgery and radiation therapy are effective against early stage MALT lymphoma, but there is no consensus of a standard surgery.
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Sun Y, Zhang H, Liu J, Xu H, Wu H, Zhai H, Lu C, Zhao X, Chen Y, Zhou L, Han J. Efficacy of radiofrequency ablation and microwave ablation in the treatment of thoracic cancer: A systematic review and meta-analysis. Thorac Cancer 2019; 10:543-550. [PMID: 30677240 PMCID: PMC6397911 DOI: 10.1111/1759-7714.12973] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Radiofrequency ablation and microwave ablation are frequently prescribed for thoracic cancer. However, few writers have been able to draw on any systematic research into the differences between the two ablation methods. METHODS A literature search was carried out using Embase, PUBMED, Web of Science, Cochrane Library, and CNKI databases, with additional searches carried out manually using terms associated with thoracic cancer and thermal ablation. Then we used Google Scholar for a complementary search. Data were extracted from studies of patients that underwent radiofrequency ablation or microwave ablation, and the investigator carried out efficacy evaluation and follow up. The data obtained from the literature were summarized and analyzed using Cochrane Revman software Version 5.3 and SPSS 22.0. RESULTS There were seven comparative studies, but no randomized studies identified for data extraction; 246 patients received radiofrequency ablation therapy and 319 controls received microwave ablation. There was no significant difference in the six-month, one-year, two-year, and three-year survival rates, and adverse reactions were found in the two treatments. For patients' long-term survival rate, the two treatments can achieve a similar survival time. CONCLUSION In the treatment of thoracic cancer, microwave ablation can achieve the same efficacy as radiofrequency ablation.
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Affiliation(s)
- Yuan‐dong Sun
- School of Medicine and Life SciencesAffiliated to University of Ji'nan‐Shandong Academy of Medical SciencesJinanChina
| | - Hao Zhang
- School of Medicine and Life SciencesAffiliated to University of Ji'nan‐Shandong Academy of Medical SciencesJinanChina
| | - Jing‐zhou Liu
- Shandong Tumor Hospital Affiliated to Shandong UniversityJinanChina
| | - Hui‐rong Xu
- Invasive Technology DepartmentShandong Tumor Hospital Affiliated to Shandong UniversityJinanChina
| | - Hui‐yong Wu
- Shandong Tumor Hospital Affiliated to Shandong UniversityJinanChina
| | - Hui‐zhuan Zhai
- Shandong Tumor Hospital Affiliated to Shandong UniversityJinanChina
| | - Chang‐yan Lu
- School of Medicine and Life SciencesAffiliated to University of Ji'nan‐Shandong Academy of Medical SciencesJinanChina
| | - Xia Zhao
- School of Medicine and Life SciencesAffiliated to University of Ji'nan‐Shandong Academy of Medical SciencesJinanChina
| | - Ye‐qiang Chen
- School of Medicine and Life SciencesAffiliated to University of Ji'nan‐Shandong Academy of Medical SciencesJinanChina
| | - Lin‐lin Zhou
- School of Medicine and Life SciencesAffiliated to University of Ji'nan‐Shandong Academy of Medical SciencesJinanChina
| | - Jian‐Jun Han
- Invasive Technology DepartmentShandong Tumor Hospital Affiliated to Shandong UniversityJinanChina
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Yang X, Jiang J, Dong X, Liang J, Guan Y. Correlations between computed tomography and positron emission tomography/computed tomography findings and pathology in 6 cases of pulmonary epithelioid angiosarcoma. Medicine (Baltimore) 2018; 97:e12107. [PMID: 30170436 PMCID: PMC6392945 DOI: 10.1097/md.0000000000012107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Previous studies on primary pulmonary epithelioid angiosarcoma (PEA) have been mostly clinical or pathological case reports. We here summarize findings from computed tomography (CT) and positron emission tomography/computed tomography (PET/CT) analyses of PEA to improve the diagnosis and differentiation of this rare tumor.We conducted a retrospective analysis of the clinical findings, radiological imaging, and pathological findings of 6 cases of primary PEA confirmed by surgery, biopsy, and pathology. All cases were evaluated by CT and x-ray prior to surgery, and 2 cases were further examined by PET/CT.CT images indicated maximum tumor diameters of 2.4 to 9.8 cm and inhomogeneous density, with 1 case exhibiting nodular calcification. Contrast-enhanced CT revealed inhomogeneous enhancement with visible necrosis in all 6 cases, while 3 cases had hilar and mediastinal lymph node metastasis. Five cases displayed extensive tumor involvement with extension into the chest wall, mild-to-moderate levels of pleural effusion, and varying degrees of volume loss in the corresponding hemithorax. One case had limited pleural thickening and invasion. Preoperative PET/CT of 1 case revealed abnormal fluorine-18 fluorodeoxyglucose (F-FDG) uptake by the tumor and multiple enlarged right hilar and mediastinal lymph nodes, right diffuse pleural thickening, and systemic multiple bone metastasis. In the other case, PET/CT scan at 7 months after surgery revealed pleural thickening and mediastinal lymph nodes with increased F-FDG uptake on the surgical side. Immunohistochemistry analyses determined that all 6 tumors were positive for CD34, CD31, ERG, and vimentin.CT and PET/CT findings reveal that malignant characteristics, including extensive pleural thickening, invasion and metastasis, and pleural effusion, are common in PEA. Imaging data are only supportive; therefore, the final diagnosis should be based on pathology and immunohistochemistry analyses.
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Affiliation(s)
| | - Juhong Jiang
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University
- Guangzhou Institute of Respiratory Health, Guangzhou, China
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8
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Abstract
Background The tubeless technique, defined as non-intubated general anesthesia with omission of chest drainage after video-assisted thoracoscopic surgery (VATS), is a new concept to further minimize surgical trauma. However, there has been little investigation into the associated feasibility and safety. Minimization of postoperative pneumothorax is challenging. We set up a "tubeless protocol" to select patients for tubeless single-port VATS with monitoring of a digital drainage system (DDS). Methods From November 2016 to September 2017, 50 consecutive non-intubated single-port VATS for pulmonary resection were performed. In our study, patients with small and peripheral pulmonary lesions indicated for sublobar resections, as diagnostic or curative intent, were included. After excluding patients having tumors >2 cm, or intrapleural adhesions noted during operation, or forced expiratory volume in the 1 second <1.5 L, 36 patients were selected for tubeless protocol. The clinical characteristics and perioperative outcomes of these patients are presented. Results Among 36 cases, 5 patients had minor air leaks detected using the DDS and required intercostal drainage after wound closure. Among the remaining 31 patients in whom the DDS showed no air leak, the chest drainage was removed immediately after wound closure. A postoperative chest roentgenogram on the surgery day showed full expansion in all patients without pneumothorax. Only 7 (19.4%) patients developed minor subclinical pneumothorax on the first postoperative day without the need for chest drainage. All patients were discharged uneventfully without the need for intervention. Conclusions Our tubeless protocol utilizes DDS to select patients who can have intercostal drainage omitted after non-intubated single-port VATS for pulmonary resection. Using objective DDS parameters, we believe that this is an effective way to reduce the rate of pneumothorax after tubeless single-port VATS in selected patients.
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Affiliation(s)
- Chao-Yu Liu
- Faculty of Medicine, National Yang-Ming University, Taipei.,Division of Thoracic Surgery, Department of Surgery, Far-Eastern Memorial Hospital, New Taipei City
| | - Po-Kuei Hsu
- Faculty of Medicine, National Yang-Ming University, Taipei.,Division of Chest Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei
| | - Hung-Che Chien
- Faculty of Medicine, National Yang-Ming University, Taipei.,Department of Surgery, National Yang-Ming University Hospital, Yilan
| | - Chih-Cheng Hsieh
- Faculty of Medicine, National Yang-Ming University, Taipei.,Division of Chest Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei
| | - Chien-Kun Ting
- Faculty of Medicine, National Yang-Ming University, Taipei.,Department of Anesthesiology, Taipei Veteran General Hospital, and National Yang-Ming University, Taipei
| | - Mei-Yung Tsou
- Faculty of Medicine, National Yang-Ming University, Taipei.,Department of Anesthesiology, Taipei Veteran General Hospital, and National Yang-Ming University, Taipei
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Tang H, Wang H, Xi S, He C, Chang Y, Wang Q, Wu Y. Perioperative chemotherapy with pemetrexed and cisplatin for pulmonary large-cell neuroendocrine carcinoma: a case report and literature review. Onco Targets Ther 2018; 11:2557-2563. [PMID: 29765234 PMCID: PMC5944445 DOI: 10.2147/ott.s160565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is associated with poor prognosis, and its treatment strategy is still controversial, especially regarding chemotherapy regimens. Case report We present the case of a 49-year-old Chinese male with primary pulmonary LCNEC treated with neoadjuvant and adjuvant chemotherapy with cisplatin plus pemetrexed. A suspected quasi-circular mass in the left lower pulmonary lobe and an enlarged mediastinal lymph node were found. The patient was diagnosed with adenocarcinoma with neuroendocrine differentiation based on computerized tomography-guided percutaneous lung biopsy. An EGFR gene mutation test showed negative results. Cisplatin and pemetrexed were administered as the neoadjuvant chemotherapy regimen. The primary lesion had reduced markedly, and the enlarged mediastinal lymph node had disappeared after two cycles of neoadjuvant chemotherapy. A left lower lobectomy and mediastinal lymph node dissection were performed. The lesion was confirmed as LCNEC based on postoperative histopathological analysis and immunohistochemical results. The patient underwent four cycles of adjuvant chemotherapy with cisplatin and pemetrexed for a month postoperatively, followed by postoperative adjuvant radiotherapy. The patient was still alive after a follow-up of 24 months, with no evidence of tumor recurrence. Conclusion Cisplatin combined with pemetrexed is effective and safe for patients with pulmonary LCNEC.
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Affiliation(s)
- Hong Tang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Hongyan Wang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Shaoyan Xi
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
| | - Chunyu He
- Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yuxi Chang
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Qiming Wang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yufeng Wu
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China
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Chen T, Jin J, Chen S. Clinical assessment of computed tomography guided radiofrequency ablation in the treatment of inoperable patients with pulmonary tumors. J Thorac Dis 2017; 9:5131-5142. [PMID: 29312719 DOI: 10.21037/jtd.2017.11.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background To enhance our understanding of the feasibility, effectiveness, safety and quality of life (QoL) of radiofrequency ablation (RFA) for inoperable patients with pulmonary tumors. Methods The data of 88 patients with pulmonary tumors undergoing RFA were collected. Proof of malignancy was obtained by biopsy in all patients. Diagnoses included non-small cell lung cancer (NSCLC) in 74 patients and pulmonary metastases in 14 patients. Patients underwent computed tomography (CT)-guided RFA according to standard protocol and had a 2-year follow-up. Results assessment included feasibility (correct placement of the ablation probe into all targeted tumors), effectiveness (overall survival rate and local control rate), safety (treatment-related complication and changes in pulmonary function) and QoL. Results One hundred and thirty-four RFAs were successfully conducted in 88 patients with 96 nodules. Correct placement of ablation probe into targeted tumors with completion of the planned treatment protocol was feasible in all 88 (100%) patients and no procedure-related deaths occurred. Major complication rate was 4.5% (4/88), which consisted of symptomatic pneumothorax (2/88) and high fever (2/88). No significant worsening of pulmonary function was observed. Tumors shrank obviously at 6 months after RFA with a statistically significance (P<0.001).The overall survival rate in 6 months, 1 year and 2 years were 100%, 95.5% and 70.5%, respectively while the local control rate in 6 months, 1 year and 2 years were 92.1%, 87.5% and 51.1% respectively. There was no significant difference of overall survival rate and local control rate between NSCLC and metastatic carcinoma. No significant worsening of QoL was observed. Conclusions CT-guided RFA is a feasible, effective and safe therapy for inoperable patients with pulmonary tumors. However, RFA could not obviously improve the QoL in the patients with pulmonary tumors. More prospective studies comparing RFA with standard non-surgical treatment options were needed.
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Affiliation(s)
- Tianming Chen
- Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China.,Department of Cancer Surgery, Yifu Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China
| | - Jiewen Jin
- Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China
| | - Shilin Chen
- Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medicinal University, Nanjing 210009, China
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Wang X, Wang L, Zhang H, Li K, Gong X. Feasibility and application of single-hole video-assisted thoracoscope in pulmonary peripheral tumors. Oncol Lett 2016; 12:4957-4960. [PMID: 28101232 PMCID: PMC5228317 DOI: 10.3892/ol.2016.5361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 08/26/2016] [Indexed: 11/06/2022] Open
Abstract
The feasibility and clinical application of single-hole video-assisted thoracoscope in pulmonary peripheral tumors was examined. From March, 2011 to March, 2015, we retrospectively analyzed the clinical data obtained from 32 patients with pulmonary peripheral tumor that received single-hole thoracoscopic surgery. We completed the surgery via a 1.5-cm incision on the seventh or eighth rib in midaxillary line as the observation hole, and a 4.0-5.0-cm incision in the lateral margin of pectoralis major in the fourth or fifth rib in midaxillary line as the operation hole. All the patients had completed the tumor-reductive surgery under single-hole thoracoscope successfully. None required second operation hole or needed a transfer to thoracotomy. Operation time was 40-100 min with an average of 65.78±15.87 min. Intraoperative blood loss was 20-100 ml, with an average of 47.19±26.91 ml. Post-operative chest drainage time was 3-6 days, with an average of 4.22±0.87 days. Hospitalization time after operation was 5-7 days, with an average hospitalization time of 5.97±0.82 days. No patient received a second surgery for pulmonary leak or bleeding and no patient had any complication. All the cases recovered without any problem. In conclusion, for patients with pulmonary peripheral tumor, single-hole video-assisted thoracoscope could further reduce their surgical trauma. The operation was safe and feasible and worthy of wide application.
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Affiliation(s)
- Xin Wang
- Department of Thoracic Surgery, The Central Hospital of Xuzhou, Xuzhou, Jiangsu 221009, P.R. China
| | - Lei Wang
- Department of Thoracic Surgery, The Central Hospital of Xuzhou, Xuzhou, Jiangsu 221009, P.R. China
| | - Hao Zhang
- Department of Thoracic Surgery, The Central Hospital of Xuzhou, Xuzhou, Jiangsu 221009, P.R. China
| | - Ke Li
- Department of Thoracic Surgery, The Central Hospital of Xuzhou, Xuzhou, Jiangsu 221009, P.R. China
| | - Xiangnan Gong
- Department of Thoracic Surgery, The Central Hospital of Xuzhou, Xuzhou, Jiangsu 221009, P.R. China
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Affiliation(s)
- Nicole L Young
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA
| | - Ruth A Houseright
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA
| | - Cecilia S Robat
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA
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Tsuchiya T, Oya S, Mori H, Matsui T. Multiple hemorrhagic intraparenchymal tumors presenting with fatal intracranial hypertension: A rare manifestation of systemic epithelioid hemangioendothelioma. Surg Neurol Int 2015; 6:156. [PMID: 26539307 PMCID: PMC4604639 DOI: 10.4103/2152-7806.166799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/30/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epithelioid hemangioendotheliomas (EHE) is an extremely rare tumor that can arise not only intracranially but also systemically. Its radiological characteristics and the mechanism underlying the multiple organ involvement in EHE are poorly understood. CASE DESCRIPTION A 24-year-old woman with a 7-month history of coughing and blood-stained sputum complained of visual disturbance in the right eye that had persisted for 1-month. Magnetic resonance (MR) imaging revealed multiple intraparenchymal masses with low-intensity on MR susceptibility-weighted images with minimal enhancement with gadolinium. Systemic computed tomography revealed multiple nodules in both lungs and the liver. Because her neurological status rapidly deteriorated, brain biopsy of the right frontal mass was performed. The pathological diagnosis was EHE. Over the following 3 months, the patient gradually developed disturbance of consciousness. She died at 4 months after admission because of significant intracranial hypertension. CONCLUSION Although intracranial EHEs are extremely rare, they should be included in the differential diagnoses of multiple small-sized masses with low-intensity on MR susceptibility-weighted images. We also emphasize that the systemic involvement of this tumor was more compatible with multicentric development than metastasis.
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Affiliation(s)
- Tsukasa Tsuchiya
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Soichi Oya
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Harushi Mori
- Department of Radiology, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Toru Matsui
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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