• 대한두개안면성형외과학회지
• /
• 제24권5호
• /
• pp.240-243
• /
• 2023

Metastasis of lung cancer to the skin is uncommon, presenting in 0.22% to 12% of lung cancer patients, and it is extremely rare for skin metastasis to be the first clinical manifestation of lung cancer. In the few cases where skin metastasis has been reported as the first sign of lung cancer, the patients were typically heavy smokers or had preexisting respiratory diseases and symptoms. This prompted clinicians to consider skin metastasis of a pulmonary malignancy. Large cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer that accounts for approximately 3% of lung cancers. LCNEC mainly metastasizes to visceral organs, such as the liver, bone, and brain, and it only shows metastasis to the skin in very rare cases. Herein, we report an unusual case of a metastatic skin lesion as the first sign of primary pulmonary LCNEC, in a 63-year-old woman with no pulmonary symptoms or personal history of smoking or pulmonary disease.

• Journal of Chest Surgery
• /
• 제39권1호
• /
• pp.76-79
• /
• 2006

폐에 발생하는 원발성 악성 흑색종은 극히 드물다. 46세 여자가 2개월간의 마른기침과 혈담을 주소로 내원하였다. 컴퓨터단층촬영 상 우측 폐하엽에 4.5$\times$5.0 cm 크기의 종괴가 관찰되어 기관지내시경 하 및 경피적 폐생검술을 반복 시행하였으나 정확한 진단이 되지 않았다. 악성 종양을 의심하고 시행한 술 전 검사에서는 전이 소견이 없어 수술적 접근을 하였다. 우하엽 폐절제술과 임파절 박리를 시행하였으며 종양과 임파절 모두 원발성 악성 흑색종으로 진단되었다. 술 후 40일째 우측 반부전마비가 있어 촬영한 뇌자기공명 영상상 좌측 두정부에 전이 소견이 있어 종양제거술을 시행하였으나 술 후 8개월째 사망하였다.

• Tuberculosis and Respiratory Diseases
• /
• 제41권1호
• /
• pp.63-67
• /
• 1994

A 70-year-old female patient was admitted due to the impression of lung abscess via local clinic. Chest P-A showed air shadow containing huge mass lesion in the right lower lung field, pericardio phrenic angle. But the patient complained of only mild upper respiratioy tract infection symptoms and the laboratory tests were within normal limits. Barium enema and chest C-T taken right after barium enema were performed in suggestion of the diaphragmatic hernia. Barium filled transverse colon and associated omentum were in the right anterior hemithorax surrounded by the hernial sac. The mass lesion shown in the chest P-A was compatible with the diaphragmatic hernia, Morgagni type. Operative reduction of the herniated bowel and simple closure of the diaphragm was performed.

• Tuberculosis and Respiratory Diseases
• /
• 제38권2호
• /
• pp.119-127
• /
• 1991

This study was designed to observe the problems in performing the screening for early detection of lung cancer, and the degree to which regular radiographic and cytologic screening contributes to the early detection of lung cancer in asymptomatic volunteers. Through mass media campaign, 346 male volunteers had registered to receive radiographic and sputum cytologic screening every four months. Initial chest x-ray examination showed 83 cases of lesions suggesting tuberculosis. Among them, two cases were proved to be active tuberculosis. The rate of long-term follw-up over two years was about 15%. The screening tests detected two cases of lung cancer, one prevalent lung cancer by sputum cytologic examination, and the other by sputum cytologic examination during follow-up. So the prevalence rate of lung cancer was 0.28% and the incidence rate was 3.1/1,000 person·years. Both were localized lesions; ie, American Joint Committee on Cancer (AJCC) stage I and occult lung cancer, respectively. With these results, we suggest that the maintenance of long-term follow-up seems to be the most important problem to evaluate the effect of early detection of lung cancer. It would require thorough explanation of the risk of smoking in lung cancer and the wide public education on the government's base. It should be done at several hospitals simultaneously to include a large population in the study. Although we couldn't determine the effect of screening for the early detection of lung cancer in this report, new diagnostic procedure other than chest x-ray and sputum cytologic examination would be required, according to the literature, to reduce the mortality of lung cancer by the screening program for the early detection of lung cancer.

• Tuberculosis and Respiratory Diseases
• /
• 제79권3호
• /
• pp.184-187
• /
• 2016

Since IgG4-related pancreatitis was first reported in 2001, IgG4-related disease has been identified in other organs such as salivary gland, gallbladder, thyroid, retroperitoneum and kidney; but lung invasion is rare. A 63-year-old man presented with hemoptysis at the pulmonary clinic and chest computed tomography revealed about 4.1 cm irregular shaped mass with spiculated margin at the left upper lobe. Despite no elevation of serum IgG4 level, he was finally diagnosed as IgG4-related lung disease by transthoracic needle biopsy. After treatment with oral glucocorticoids, hemoptysis disappeared and the size of lung mass was decreased.

• Journal of Yeungnam Medical Science
• /
• 제34권2호
• /
• pp.275-278
• /
• 2017

Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

• Journal of Chest Surgery
• /
• 제27권12호
• /
• pp.1015-1022
• /
• 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.

• Journal of Chest Surgery
• /
• 제35권12호
• /
• pp.909-913
• /
• 2002

대세포 신경내분비암은 드문 질환으로, 최근에 폐의 신경내분비암의 하나로 진단 기준이 확립되었다. 심한 흡연자로 증상이 없는 74세의 남자가 우하엽의 종양을 주소로 내원하였다. 세침 생검을 통해 대세포 신경내 분비암으로 진단되었다. 우하엽 절제술과 종격동 림프절 곽청술을 시행 받았다. 저자들은 대세포 신경내분비암의 한 례를 치험하였고 문헌고찰과 함께 보고한다.

• Journal of Chest Surgery
• /
• 제35권4호
• /
• pp.311-314
• /
• 2002

간헐적 우측 흉부 동통을 호소하는 48세 남자 환자로 단순 흉부 방사선 촬영상 우측 중폐야에 거대 종괴가 관찰되어 우측 쌍폐엽 절제술 후 대세포 신경 내분비 암으로 진단되어진 1예를 치험 하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제25권9호
• /
• pp.900-904
• /
• 1992

Pulmonary blastoma is a very rare, primary, malignant neoplasm of the lung. The tumor typically is large, well-defined mass and arises in the periphery of the lung. Histologically, it resembles fetal lung tissue evoking the concept that these tumors are drived from the primitive pluripotential pulmonary blastema, but controversy also exit about the nature of this tumor. Clinical evaluation is inconsistant and unreliable as to the diagnostic determination of the tumor type and degree of malignancy. Therefore, diagnosis is usually based on histologic findings. The prognosis after adequate resection appears to be better than for other malignant tumors of the lungs. We experienced a case of pulmonary blastoma occurring in 56-year-old female. She was hospitalized for evaluation of an abnormal shadow in the left lower lung field which found incidentally on chest roentgenogram. We approached the lesion though left posterolateral thoracotomy and performed the left lower lobectomy. The microscopic findings of resected specimen revealed characteristic appearance of pulmonary blastoma. The postoperative course was uneventful without complication.