• Title/Summary/Keyword: chest wall neoplasm

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A Case of Pulmonary Actinomycosis (폐의 방선균증 1예)

  • Jang, Jie-Jung;Kim, Sung-Su;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Han, Ki-Don;Moon, Hwa-Sik;Song, Jong-Sup;Park, Sung-Hak;Seo, Eun-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.438-442
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    • 1992
  • Actinomycosis is a chronic suppurative infection characterized by extensive necrosis, fibrosis and sinus formation without regard to normal tissue planes. The causative organism in human infection is Actinomyces israelii. Thoracic actinomycosis is diagnosed in the presence of poor oral hygiene, pulmonary infiltrate, empyema, sinus tract and osteomyelitis of ribs. However, in the absence of chest wall involvement, the diagnosis of pulmonary actinomycosis is difficult and its initial clinical manifestations may lead physicians to suspect tuberculosis or neoplasm. It could not be distinguished from tuberculosis or neoplasm radiologically. We report a case of pulmonary actinomycosis in a 64 year old woman with a review of the literature.

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Extraosseous Epidural Ewing's Sarcoma Arising in the Lumbar Area - A Case Report- (요추부에 발생한 경막외 유잉육종 - 증례 보고 -)

  • Ahn, Myun-Hwan;Shin, Duk-Seop;Jung, Kwang-Am;Hah, Jeong-Ok
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.3
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    • pp.183-189
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    • 1999
  • Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.

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Subcutaneous Sparganosis on Abdomen Mimicking Multiple Lipomas

  • Ahn, Seung Ki;Choi, Hwan Jun;Kim, Jun Hyuk
    • Parasites, Hosts and Diseases
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    • v.57 no.5
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    • pp.513-516
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    • 2019
  • Human sparganosis is a food-borne zoonosis mainly caused by the plerocercoid belonging to the genus Spirometra. The most common clinical sign of sparganosis is a subcutaneous mass in the trunk including abdominal or chest wall. The mass may be mistaken for a malignant tumor, thereby causing difficulty in terms of diagnosis and treatment. A 66-year-old woman visited our clinic for the removal of a lipoma-like mass. It was movable, hard, and painless. we identified 2 white mass, measuring $0.2{\times}4cm$ and $0.2{\times}1cm$. Pathologic finding indicated the white mass was a sparganum. She recalled having eaten a raw frog approximately 60 years before. A 35-year-old who lived North Korea was also presented to our clinic with an asymptomatic nodule on her abdomen. Intraoperatively, we found sparganum approximately 24 cm size. Subcutaneous masses are associated with clinical signs of inflammation or they may mimic a soft tissue neoplasm. While the incidence rate of sparganosis has decreased with economic development and advancements in sanitation, surgeons still encounter patients with sparganosis in the clinical setting. Therefore, a careful history is required in order to diagnose sparganosis.

Clinical Application for Video-Thoracoscopy in Lung Cancer Surgery Patients (폐암 수술환자에서 흉강경수술의 적용)

  • 김광호;한재열;윤용한;백완기;이응석;김형진
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.392-396
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    • 2002
  • Background: Video-thoracoscopy is known to be an useful method to provide accurate pre-resectional staging in patients with lung cancer in addition to the conventional radiologic studies and mediastinoscopy, for the pleural cavity is inspected directly and biopsy specimens call be obtained. This study is undertaken to evaluate how video-thoracoscopy can be used in deciding pre-resectional stage Material and Method: Video-thoracoscopy was performed in patients with lung cancer who were scheduled for surgical resection based on the radiologic staging and mediastinoscopic biopsy. 37 patients were included in this study. Pre-thoracoscopically 18 cases were in TNM stage 1, 7 in stage 2, and 12 in stage 3. Result: In 15 of 37 cases, video-thoracoscopy could not be performed effectively due to heavy adhesions in the pleural cavity, diaphragmatic and chest wall invasion of tumor and bulky tumor mass es. Mediastinal lymph nodes were positive postresectionally in 6 of these 15 cases. In 22 cases, video-thoracoscopy was performed as usual. Positive mediastinal lymph nodes were identified in 2 cases and exploratory thoracotomy was prevented. Surgical resection were carried out in remaining 20 cases and 5 cases among them had positive mediastinal lymph nodes. Conclusion: We believe that it is difficult to perform pre-thoracotorny video-thoracoscopy for all lung cancer patients for there were many cases that thoracoscory could not be undertaken doe to heavy adhesions in the pleural cavity, tumor involvement of the chest wall and/or diaphragm and bulky tumor mass. However we think it is helpful in preventing unnecessary exploratory thoracotomy for some patients with lung cancer whom pre-thoracotomy video-thoracoscopy was carried out.

Myxofibrosarcoma Originating from Chest Wall (흉벽에서 발생한 점액성섬유육종)

  • Cha, Byung-Ki;Lee, Mi-Kyung;Lee, Sam-Youn;Choi, Chong-Bum;Choi, Soon-Ho
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.166-170
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    • 2006
  • Myxofibrosarcoma represents one of the most common soft tissue sarcomas of the extremities in adult and elderly patients. However, it only rarely occurs in the chest wall. A 58 years old woman presented with a huge painless lump (8 ${\times}$ 6.5 cm) in the right lower parasternal area which recurred a few months following excision from General surgery of our hospital. Histology showed an infiltrative deep seated dermal and subcutaneous tumor. It had a distinctive lobular growth pattern with prominent myxoid change and moderate cellularity. Tumor cells were spindleshaped with varying degrees of pleomorphism and frequent mitotic figures. Numerous blood vessels with curvilinear growth pattern were also seen. Immunostains for S-100, CD68, Mac 387, and FX IIIa were all negative, but positive for Vimentin. The histologic feature was of an intermediate grade myxofibrosarcoma. Wide excision was performed and recovered in good condition without any physical disabilities and was discharged at one month later. Currently she is waiting for the skin graft without chemotherapy and radiotherapy.

Clinical Experience of Cardiac Myxoma (심장점액종의 임상적 경험)

  • 김종원;전상협
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.311-314
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    • 1996
  • Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

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A Case of Dedifferentiated Chondrosarcoma : It was Changed From a Hamartoma (과오종에서 악성화된 탈분화형 연골육종 1예)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jung, Eun-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.645-650
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    • 2002
  • Extraosseous pulmonary chondrosarcoma is rare neoplasm, which is characterized into two groups. One is termed a primary chondrosarcoma, and arise de novo (bronchial cartilage), the other is termed a secondary chondrosarcoma, and is superimposed on preexisting benign cartilagenous neoplasms, such as a chondroma or hamartoma. The preferred treatment is surgical resection. We recently experienced a secondary chondrosarcoma changed from a hamartoma. A 54-year-old woman was referred to our hospital because of an abnormal chest X-ray with mild dyspnea. We performed a percutaneous transthoracic needle biopsy and sputum examination. The abnormal mass had been diagnosed as a chondromatous hamartoma with active pulmonary tuberculosis, which had been treated with anti-tuberculosis regimens. Despite her medication, an abnormal mass had grown. Therefore, we undertook a pneumonectomy with chest wall reconstruction. Histopathologically, the mass was a grade II, dedifferenciated chondrosarcoma, with chronic granulomatous inflammation and necrosis. We suggest this case had changed from a chondromatous hamartoma to a dedifferentiated chondrosarcoma, with associated pulmonary tuberculosis. We report this case with a brief literature review.

Primary Pulmonary Artery Osteosarcoma Mimicking Acute Pulmonary Artery Embolism - A case report- (급성 폐동맥 색전증으로 의심된 원발성 폐동맥 골육종 -1예 보고-)

  • 박상현;손정환;지현근;신윤철;유병수;박우정;박혜림;김응중
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.929-932
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    • 2004
  • The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.

Treatment of Tumor Involving Thoracic Inlet by Using Transmanubrial Osteomuscular Sparing Approach - One case report- (흉강입구를 침범한 종양의 근골보존 경흉골병 접근술을 이용한 치유 -1예 보고-)

  • Choi Chan Young;Kim Wook Sung;Ryoo Ji Yoon;Chang Woo Ik;Kim Min-Kyung;Cho Seong Joon;Kim Yeon Soo
    • 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.

Cardiac Malignant Mesenchymoma - Two Cases Report - (심장의 악성 간엽세포종 - 2례 보고 -)

  • Ku, Gwan-Woo;Kang, Shin-Kwang;Won, Tae-Hee;Kim, Si-Wook;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.750-754
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    • 2002
  • Primary cardiac tumors are rare and about 20~25% of primary cardiac tumors are malignant. Moreover, primary malignant mesenchymoma of the heart is extremely rare. Recently, we have experienced two cases of cardiac malignant mesenchymoma. In the first case, malignant mesenchymoma which was originated from the posterior wall of the left atrium obstructing the mitral orifice was revealed pathologically in a 61-year-old woman with mitral regurgitation. The mass, which was 2.7$\times$3.7cm in size on the posterior wall of left atrium, was extended to the posteromedial commissure and annulus of the mitral valve. The mass was resected partially without excision of the left atrial free wall. She was discharged after 30 days without any problems and she received chemotherapy and followed up for 19months. The second case was a 4$\times$5cm in size, friable, yellow-whitish multilobulated mass in the left atrium which was originated from the left lower pulmonary vein. Multiple minor tumor nodules were found in the wall of the left atrium and the posterior leaflet of mitral valve. Partial mass excision and mitral valve replacement were performed.