• Title/Summary/Keyword: Mediastinal disease

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Neurofibromatosis (Von Recklinghausen's Diseased) in Mediastinum -3 case- (종격동에 발생한 다발성 신경섬유종증 -3례 보고-)

  • Pyeon, Seung-Hwan;Jeong, Il-Yeong;Choe, Pil-Jo;U, Jong-Su
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.120-124
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    • 1996
  • We report three cases of posterior mediastinal tumor in Von Recklinghausen's disease on 12-yearsy old boy, 8-years-old girl and 6-years-old boy. Especially the last case was combinded with "Dumbbell" neurilemmoma of cervical spine. In the first case, preoperative CT scan showed a homogeneous large mass In the posterior mediastinum. But the mass did not show intraspinal invasion on the chest MRI scan. In the last case, cervical spine CT with thecal enhancement shows dumbbell shaped neurofibroma, compressed spinal cord and thecal sac In three cases we removed all the masses successfully and the patients were discharged safely without significant problem.t problem.

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A Novel Mediastinal Drainage Tube for Mediastinitis

  • Yhang, Jun Ho;Jang, In-Seok;Kim, Sung Hwan;Park, Hyun Oh;Kang, Dong Hoon;Choi, Jun Young
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.378-379
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    • 2015
  • Mediastinitis is a life-threatening disease, and effective drainage is needed to treat mediastinitis with abscess formation. We recommend an alternative drainage method using chest tube binding with a Silastic Penrose drainage tube. The use of a Silastic Penrose drainage tube may help to manage mediastinitis with abscess formation. This method facilitates effective draining and prevents tissue adhesion.

The Usefulness of FNAB for the Diagnosis of Thoracic Surgical Disease (흉부외과 질환의 진단시 FNAB 의 유용성과 객담세포검사 및 기관지 내시경 검사와의 비교 고찰)

  • 유정훈
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1225-1232
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    • 1990
  • From March 1986 to June 1990, the percutaneous Fine Needle Aspiration Biopsy[FNAB] of 102 thoracic lesions were performed with Westcott needle [slotted 20G or 22G thin needle], for the purpose of identifying and diagnosing thoracic lesions. There were 94 lung lesions [67 malignant tumors, 27 benign lesions] and 8 mediastinal and chest wall lesions. The results of FNAB were compared with sputum cytology and bronchoscopic examinations. The sputum cytologic examinations were performed in 54 cases of malignant lung tumor and the malignant cell was found at the 18 cases [33%]. We bronchoscopic examinations were performed in 24 cases and the malignant cell was found at the 12 cases [55%]. The positive diagnostic rate of malignancy was 100% by FNAB. Among them, 55 cases [82%] were diagnosed by cytologic examinations and 43 cases[64%] by both. The specific diagnoses for benign lung lesions in 15 cases[55%] and for mediastinal and chest well lesions in 5 cases[62%]. The 7 patients[6.9%] developed the pneumothorax and 5 of them required the treatment. Therefore, the FNAB of thoracic lesions may be a preferred diagnostic method because of its safety, simplicity and accuracy.

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Ectopic Pancreas with Hemorrhagic Cystic Change in the Anterior Mediastinum

  • Byun, Chun-Sung;Park, In-Kyu;Kim, Hyun-Ki;Yu, Woo-Sik
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.131-133
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    • 2012
  • A 31-year-old female was referred from other hospital due to migrating chest pain, mild cough, and blood-tinged sputum for three days before admission. Laboratory tests were unremarkable. Chest computed tomography revealed an elliptical necrotic mass at the left anterior mediastinum, measuring $7{\times}3{\times}4cm$. With the impression of mediastinal abscess or loculated empyema, thoracoscopic resection was performed. There was severe pleural adhesion around the mass. The mass could be resected by the wedge resection of the adhesed upper lobe tissue of left lung around the mass. Final pathologic diagnosis was ectopic pancreas.

Descending Necrotizing Mediastinitis Combined with Cervical Spine Injury (경추 손상과 동반된 하행성 괴사성 종격동염)

  • 금동윤;양보성
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.76-79
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    • 2001
  • A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

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Clinical Review of Primary Tumors and Cysts of the Mediastinum (원발성 종격동 종양 및 낭종의 임상적 고찰)

  • 장기경
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.689-694
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    • 1994
  • A retrospective analysis was performed on 36 patients with primary cysts and tumors of the mediastinum seen at the Department of Thoracic and Cardiovascular Surgery of Maryknoll Hospital from January 1983 to December 1993. There were 21 female and 15 male patients in the study. Ages ranges from 2 years to 72 years, with a mean of 34.7. There were 9 malignant tumors and 27 benign tumors.Thymic neoplasms were the most common. For the whole series, 29 of the patients had tumors in the anterior mediastinum. There appears to be an in6rease in tumors in the anterior compartment. There were 30 symptomatic patients in our series. Of the patients with malignant disease, 89 % were symptomatic. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation. There were 9[27.3 %] postoperative complications. There was no postoperative mortality. Follow-up was available on 27 patients. There was no recurrence, malignant degeneration, or growth of any tumor. It is hoped that careful evaluation and aggressive treatment of mediastinal tumors will continue to provide improvement in the prognosis for these patients.

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Intrapericardial Pericardial Cyst - A case report - (심막 내에 위치한 심막 낭종 - 1예 보고 -)

  • Kim, Jeong-Won;Cho, Suk-Ki;Do, Young-Woo;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.781-784
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    • 2009
  • Pericardial cyst is an uncommon congenital mediastinal tumor. The majority of pericardial cysts are located in the right cardiophrenic angle, but rarely they can be located intrapericardially. We now present a case of a huge intra-pericardial pericardial cyst excised with video-assisted thoracoscopic surgery.

Thoracic Chordoma Misdiagnosed as Primary Adenocarcinoma of the Mediastinum

  • Yoon, Seung Keun;Moon, Mi Hyoung;Moon, Seok Whan
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.158-161
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    • 2021
  • Chordoma is a rare malignant bone tumor originating from the embryonic notochord. Herein, we present a case of thoracic chordoma located at T3-T5 that was misdiagnosed as primary mediastinal adenocarcinoma. The patient underwent neoadjuvant chemoradiation and the disease showed little response. Due to vertebral body invasion, we performed en bloc mass removal and partial corpectomy (T4-5) in collaboration with orthopedic surgeons.

Prognostic factors in children with extracranial germ cell tumors treated with cisplatin-based chemotherapy

  • Kim, Jinsup;Lee, Na Hee;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Seo, Jeong-Meen;Lee, Suk-Koo
    • Clinical and Experimental Pediatrics
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    • v.58 no.10
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    • pp.386-391
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    • 2015
  • Purpose: To evaluate the outcomes and prognostic factors in children with extracranial germ cell tumors (GCTs) treated at a single institution. Methods: Sixty-six children diagnosed with extracranial GCTs between 1996 and 2012 were included in the study. Primary treatment was surgical excision, followed by six cycles of cisplatin-based chemotherapy. The survival rates were compared according to the International Germ Cell Cancer Cooperative Group classification used for GCTs in adults to validate the classification guidelines for GCTs in children. Results: The median patient age was 4.4 years. In 34 patients (51.5%), the primary tumor site was the gonad. Extragonadal GCTs were detected in 32 patients. The 5-year overall survival and event-free survival (EFS) were $92.0%{\pm}3.5%$ and $90.4%{\pm}3.7%$, respectively. In univariate analysis, tumor histology, metastasis, and elevated alpha-fetoprotein were not prognostic factors in children with extracranial GCTs. However, EFS was poorer in patients with mediastinal disease (n=12, $66.7%{\pm}13.6%$) than in those with nonmediastinal disease (n=54, $96.0%{\pm}2.8%$) (P=0.001). The 5-year EFS was lower in patients older than 10 years, (n=21, $80.0%{\pm}8.9%$) compared with those younger than 10 years (n=45, $95.2%{\pm}3.3%$) (P=0.04). Multivariate analysis identified the mediastinal tumor site as the only independent prognostic factor. Conclusion: The prognosis of children with extracranial GCTs was favorable. However, nongerminomatous mediastinal tumors were associated with poor survival in children. Further research is needed to improve the prognosis of children with malignant mediastinal GCTs.

The Evaluation of Video-Assisted Thoracic Surgery (비디오 흉부수술의 평가)

  • Seong, Suk-Hwan;Kim, Hyeon-Jo;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1015-1022
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    • 1994
  • Over the past few years, video-assisted thoracic surgery [VATS] has been used increasingly for intrathoracic pathologic problems as a less invasive operative techniques. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indications. Using video-assisted operative thoracoscopy, we performed consecutive 150 operations on 148 patients during the initial 2 years of our experience from July 1992 with the following indications: pneumothorax [n=53], hyperhidrosis [n=29], mediastinal mass [n=23], pleural disease [n=13], diffuse parenchymal or interstitial lung disease [n=12], benign pulmonary nodule [n=7], metastatic lung mass [n=3], primary lung cancer [n=3], bronchiectasis [n=2], malignant pericardial effusion [n=2], endobronchial tuberculosis [n=1], esophageal achalasia [n=1], and pulmonary parenchymal foreign body [n=1]. There were no death, and overall complicaton rate was 24.0%[n=36]. The most prevalent complication was persistent air leakage [longer than 5 days] in 14 cases [9.3%]. Persistent pleural effusion [longer than 5 days] occurred in 6 cases [4.0%]. Six patients were converted to an open thoracotomy because of inability to control the operative bleeding [n=3], failed adhesiolysis in bronchiectasis [n=2], and radical excision of an lung cancer [n=1]. Pneumothorax recurred in 3 cases[2.0%]. Other complications were Horner`s syndrome, diaphragm tears, temporary phrenic nerve palsy, hoarseness, subsegmental atelectasis, transient respiratory difficulty, and esophageal mucosal tear. The advantages of this minimally traumatizing operative technique lie in improved visualization, decreased pain, shortened hospital stay, and less postoperative morbidity. The indications of VATS has been extended increasingly to intrathoracic pathologies, but its role in the managements of primary lung cancer and esophageal disease remains to be defined.

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