• Journal of Chest Surgery
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• v.37 no.10
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• pp.845-855
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• 2004

Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (＋) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (＋) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (＋) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (＋) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (＋) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.542-549
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• 2002

Purpose : The purpose of our study was to assess the usefulness of the Tl-201 SPECT for the detection of the postoperative tumor recurrence on chest wall. Methods: 28 patients including 14 with suspected recurrence of tumor in the chest wall on postoperative chest cr scan, 10 with postoperative pleural effusion which proved benign on radiologic, cytologic and laboratory findings, and 4 with chronic tuberculous empyema as control group were included. All patients underwent SPECT 30 minutes and 4 hours after intravenous injection of 111MBq of Tl-201. Tumor uptake was visually graded by two interpreters and scored as follows : no uptake:0, similar to contralateral lung: 1, higher than contralateral lung but less than heart:2 and similar to heart:3. Results : Markedly increased (grade 3 or 2) Tl-201 uptake was noted in patients with suspected recurrence of tumor in the chest wall (13/14) whereas no (8/10) or minimal (2/10) uptake along the collapsed lung in patients with postoperative benign pleural effusion. In two patients, Tl-201 SPECT revealed additional recurrent tumor mass lesions that were barely perceptible on chest cr scan. Patients with chronic tuberculous empyema showed relatively smoothly marginated increased uptake along the chest wall 4/4), but lesser in degree (grade 1 or 2), when compared to recurrent tumor uptake. Conclusion : Tl-201 lung SPECT seems to be useful to detect postoperative tumor recurrence on chest wall and to differentiate malignant from benign pleural effusion and may provide additional information to the morphologic data obtained by CT.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.47-50
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• 2003

Pulmonary carcinoid tumors are thought to Originate from neuroendocrine Kulchitsky's cells in the bronchial epithelium. The majority of typical carcinoid tumors arc located centrally. However, atypical carcinoids are frequently situated peripherally and display malignant histologic features with aggressive behavior. Few reports arc discribing carcinoid tumors originating from the pleura. We report a typical carcinoid tumor located mainly in the parietal pleura invading the chest wall wilhout evidence of pulmonary parenchymal invasion.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.395-397
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• 2007

Lipoblastoma is a rare benign mesenchymal tumor that occurs primarily in infancy and childhood. There are two types of lipoblastoma: focal or diffuse (lipoblastomatosis). This is typically located in the extremities, and less frequently in the trunk, head and neck, and the retroperitoneum. Lipoblastoma is a tumor with a good prognosis with no reported metastasis, despite of its potential for local invasion, local recurrence and rapid growth. Complete surgical resection is essential for treatment, and long term follow up is needed.

• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.98-101
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• 2008

Leiomyosarcoma is an uncommon soft tissue sarcoma of mesenchymal cell origin, which shows smooth muscle differentiation. Leiomyosarcoma is seldom found in the pediatric population, and accounts for fewer than 2% of all soft tissue sarcomas. Leiomyosarcoma of the chest wall is extremely rare in children. We report here a case of an 8-year-old boy with a primary leiomyosarcoma that was incidentally found as a rib mass. The patient underwent a complete resection for a suspected osteochondroma diagnosed by a three-dimensional chest computed tomography examination. Pathological findings of the mass revealed intersecting fascicles of spindle cells showing cigar-shaped nuclei, inconspicuous nuclear pleomorphism and occasional mitotic figures in the background of a suspected osteochondroma of the rib. This report documents the first description of a leiomyosarcoma possibly arising in an osteochondroma of the rib in a child.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.580-585
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• 1999

Neurilemmoma is a benign nerve sheath tumor derived from Schwann cells and occurs in the head, neck, flexor regions of the extremities, posterior mediastinum but extremely rare in the chest wall. They occur at all ages but are most common in persons between the ages of 20 and 50 years and develop spontaneously or possible as a result of trauma or irritation. The diagnosis of a neurilemmoma is confirmed histologically by the findings of Verocay bodies, Antoni A and B tissue patterns and the presence of S-100 protein. We experienced a case of chest wall neurilemmoma which was treated by local excision and report it with a brief review of the literature.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.486-489
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• 1980

16 cases of the chest wall tumors that had been treated at the dept. of thoracic & cardiovascular surgery, Chungnam National University Hospital, for 3.5 years from Jan. 1977 to Jun. 1980 were analyzed. The results were as follows; 1. Generally the chest wall tumors were most frequent in the thirties, the youngest age was 2 years, and the oldest 65 years. The incidence rate of male to female was 1.3:1. The malignant tumors were common in the fifties & sixties, the incidence rate of male to female 5:1. 2. The common disease entities were rib tuberculosis [43.7%] and metastatic tumor [25.0%], and the another chondrosarcoma, osteosarcoma, fibrous dysplasia, chronic osteomyelitis, and granuloma accompanying with acute osteomyelitis by Klebsiella infection were 6.3%, respectively. 3. The common manifestations were local swelling [100.0%] and local chest pain [43.8%].

• Journal of Chest Surgery
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• v.17 no.3
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• pp.516-521
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• 1984

We have experienced 131 cases of chest wall tumor, from April 1974 to April 1984 at the Kyung Hee University hospital. We analyzed 131 cases of chest wall tumors, 59 cases were primary chest wall tumors and 72 cases were secondary chest wall tumors. The results were following; 1.Of primary benign chest wall tumors [56], lipomas were most common and located mainly in the scapular area [37/56]. 2.Of secondary malignant chest wall tumors [72], which originated from hung tumors were most common [27/72], & breast [8/72], liver [8/72], prostate [6/72] & stomach [3/72] were followed lowed in orders. 3.We excluded out the Rib tuberculosis.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.723-729
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• 1987

A retrospective study of 21 cases of chest wall tumors, 12 benign and 9 malignant, was carried out to review their clinical radiological and pathological features. On age distribution, most cases [80.9%] were found in 4th to 6th decades. The sex ration [M:F] was represented as 2.5:1. Of the 21 lesions, there were 8 cases of soft tissue tumors, 4 cases of bone and cartilage origined tumors and 9 malignant tumors which included 3 metastatic tumors. The overall mortality was 22.2% and all of the deaths were found in the malignant tumors. All of the patients with benign tumors were treated by excision without recurrence. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissue were visualized. On the basis of our analysis, we believe that all tumors of chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain as adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.466-469
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• 2010

We report here on a very rare case of granulocytic sarcoma of the pectoralis muscle on the left chest wall of a patient with chronic myelogenous leukemia, and this malady presented as a very rapidly growing hematoma-like mass.