• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.343-346
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• 2006

An 81-year-old woman was admitted to our hospital with bilateral chest wall mass in the infrascapular region. Considering the possible diagnosis of a malignant chest wall tumor at such location, we performed excision and biopsy. Both masses were histologically diagnosed as elastofibroma. We experienced this rare disease, bilateral elastofibroma, so we report this case with a bibliography.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.907-910
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• 1998

Primary leiomyosarcoma is an extremely rare tumor. We exprienced a case of 46-year-old man with a mass located in the left upper lobe bronchus which was discovered on a chest CT. Cytology of the sputum and bronchoscopic biopses did not reveal any malignant cells. The patient underwent a left sleeve upper lobectomy. The tumor was growing from the left upper lobe bronchus and had partially destroyed the lung parenchyme. The pathologic feature of the tumor was composed of fascicular arrayed cellular spindle cells with blunt-ended nuclei revealed mild to moderate pleomorphism and frequent mitoses (15/10HPF). The immunohistochemical staining was revealed positive reaction for antibody to smooth muscle actin and desmin. We conclude that the tumor is leiomyosarcoma of the lung and then report with a review of the literatures.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.809-812
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• 2004

Chest wall metastases from malignant tumors are rare and the majority of them are from adjacent structures such as the breast, lung, pleura, and mediastinum. Paticularly, chest wall metastases from distant organs are an even rarer event. There are few reports of chest wall metastasis with obscure or absent primary tumor. A 51-year-old man was diagnosed with metastatic hepatocellular carcinoma after an operation for a palpable mass on his left upper chest wall, At that time, there was no evidence of primary hepatocellular carcinoma in the liver after various examinations. We report a case of chest wall metastasis from unknown primary hepatocellular carcinoma.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1148-1151
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• 1996

For the purpose of clinical analysis In mediastinal tumors, 51 patients with mediastinal tumor who were surgically treated from February 1984 to February 1994 in Chunan hospital of Soonchunhyang university were reviewed. There were 21 male and 30 female patients in the study. Age ranges from 11 months to 75 years, with the mean 39.4$\pm$ 18.8 years. Symptoms and signs were asymptom(21.6%), chest d scomfort(19.6%), dyspnea(15.7%), ptosls(15.7%), general weakness(13.7%) and chest pain(9.8%). The most frequent tumor location was anterosuperior mediastinum(60.8%) followed by posterior(25.5%) and middle(13.7%) mediastinum. In the pathological viewpoint, thymoma(33.3%) was the most frequent type followed by neurogenic tumor(25.5%) an'd germ cell tumor(19.6%). All of benign tumors(46 cases) were completely removed and malignant tumors(5 cases) were treated with rAdiotherapy after operation. The postoperative complications were 2 wound dehesences, 1 pneumothorax, 1 vocal cord palsy and 1 prolonged mechanical ventilation.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.168-171
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• 2005

Solitary fibrous tumor is an uncommon sybnesitgekuak mesenchymal neoplasm that arises primarily from the pleura. Extrapleural solitary fibrous tumors are rare. Solitary Fibrous tumors are often asymptomatic and discovered incidentally but may become symptomatic when vital structures are involved or they grow large. In general, solitary fibrous tumor is diagnosed on the basis of radiologic findings and its histologic features, with immunohistochemistry serving to support the diagnosis. Most solitary fibrous tumors pursue a benign course, and the single most important predictor of clinical outcome is the ability to excise the entire lesion. We experienced a case of intrapulmonary solitary tumor arising from the right lower lobe which was treated with wedge resection. We report this case of the patient.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.175-179
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• 2005

The operative case of transmanubrial osteomuscular sparing approach for the tumor involving thoracic inlet is reported. A 69-year-old man visited the hospital due to right upper extremity weakness. Chest roentgenogram showed bronchiectasis, chronic pulmonary tuberculosis, and fungal ball in right upper lobe. On computed tomogram, tumor was located in epidural space of the 6th, the 7th cervical, and the 1st thoracic spine and extended to the apex of the right thorax. A neurosurgeon performed laminectomy and removed the tumor located in the spinal canal. A thoracic surgeon performed a transmanubrial osteomuscular sparing approach and removed the tumor involving thoracic inlet. The tumor was diagnosed as hemangiopericytoma. The patient recovered without complication.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.175-181
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• 2003

Primary chest wall tumors originate from soft tissue, bone or cartilage of the chest wall and it comprises 1∼2% of all primary tumors. Resection of tumor is often indicated for chronic ulceration or pain, and long-term survival might be achieved after surgery depending on the histology and the surgical procedure. Material and Method: Retrospective study of 125 primary chest wall tumors (86 benign, 39 malignant) operated between Sep. 1976 to Mar 2001 were reviewed and their clinical outcomes were analyzed. Follow-up data were collected at the outpatient clinic. Result: All patients with benign tumors were treated by excision without recurrence or death, and most malignancies were treated by wide resection. Malignant fibrous histiocytoma and chondrosarcoma constituted 46.2% of the malignant neoplasm. There was no operative death. The overall 3-year survival for patients with primary malignant neoplasm was 76.0%, and the 10-year survival was 60.5%. All deaths were disease-related and the tumor recurred in 11 patients. There was no significant difference in survival between patients with resection margins less than 4 cm and those with resection margins greater than 4 cm. Conclusion: Chest wall resection offers excellent results for benign chest wall tumors and substantial long-term survival for malignant diseases. Safe resection margin of 4 cm or more did not correlate with the survival rate although the tumor recurrence correlated with poor survival.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.703-709
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• 2008

Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.76-79
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• 2005

The coexistence of mesenchymal tumor and carcinoma in the esophagus is extremely rare. We report a case of squamous cell carcinoma located at the mucosal surface over leiomyoma of the esophagus. A 76-year-old man with complaints of 3 months onset of odynophagia was diagnosed preoperatively as squamous cell carcinoma over submucosal tumor with calcification. Esophagectomy and esophagogastrostomy were performed through the right thoracotomy and upper median laparotomy. The patient is doing well without evidence of recurrence in the 25 months after resection. We discuss the pathogenesis and possible relations between the two tumors.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.708-712
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• 1997

We report on nine years experience of surgical treatment of mediastinal tumors in 47 patients. Their ages ranged from 5 o 67 years with an average of 36.4 years and the sex ratio of male and female was 1:1.5. The most frequent symptom was chest pain(27.7%), followed by ptosis(14.9%), general weatuless(12.8%) and eight patients(17.0%) were asymptomatic. The most prevalent location of the tumor was anterosuperior mediastinum(63.8%). Pathologically, thymoma(32.9%) was the most common tumor, followed by cyst(21.3%), neurogenic tumor(17.0%), germ cell tumor(12.8%), and mesenchymal tumor(6.4%). Complete removal was achieved in 41 cases of all benign tumors and 3 cases of malignant tumors. All the malignant tumor patients were treated with chemotherapy, radiotherapy or both after surgery. Postoperative complications developed in 4 cases and there was no operative death.