Closure with bronchial wall flap and omental pedicle of defect caused by dehiscence of tracheal suture line after extended right upper sleeve lobectomy.
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Aged↗
Biomedical subjects
G Hori
Publications and source records attributed to G Hori.
Angiosarcoma of the chest wall.
Angiosarcoma is a rare but highly malignant disease. This report presents a 22-year-old male who has survived a primary angiosarcoma arising from the chest wall. The patient had been complaining of anterior chest pain for 3 years. CT and MRI revealed a tumor protruding into the right thoracic cavity from the anterior chest wall but no further findings. First, the tumor was resected using video-assisted thoracoscopy. The pathological diagnosis established from a frozen section was of a benign mesothelioma, but this was changed to angiosarcoma based on findings from a paraffin-embedded specimen. As a consequence, the third rib and intercostal muscles were resected in a second operation. Three years following surgery there was no evidence of tumor recurrence or metastasis. This case supports a suggestion that not all patients with angiosarcomas experience the same level of malignancy.
Adult↗
A case of malignant Triton tumor of the lung.
The present paper reports a 28-year-old male with an asymptomaticmalignant Triton tumor of the lung. Chest radiographs revealed a mass in the left hilum. The left lower lobe including the tumor and the mediastinal lymph node was resected. There was no metastasis or tumor recurrence during the one-year period following the surgical procedure. To our knowledge, this is the first case report of a primary pulmonary malignant Triton tumor.
Adult↗
Intrathoracic malignant peripheral nerve-sheath tumour associated with lipoma.
A 76-year-old woman presented with an intrathoracic malignant peripheral nerve-sheath tumour accompanied by mediastinal lipomas. The tumours were resected, but the schwannoma recurred 4 months later. The patient died of pneumonia after a second operation. To our knowledge, this is the first published case of malignant intrathoracic tumour of nerve-sheath origin associated with lipomas.
Aged↗
Reconstruction of chest wall after full-thickness resection. Two case reports.
Full-thickness reconstruction to repair defects in the chest wall was performed with a new method, using Marlex mesh, artificial bones and musculocutaneous flap. The artificial bones were constructed from ceramic iliac crest spacers connected by wires and methyl methacrylate. The advantage of the method is that the artificial bone can be created in various lengths and curves, tailored for the individual defect.
Adenocarcinoma↗
[Therapy of acute empyema thoracis using thoracoscopic instruments].
Adequate pleural drainage is imperative for the treatment of acute empyema thoracis. But chest tube drainage sometimes cannot operate effectively if blocked by intrathoracic loculations. We successfully treated two cases of acute empyema thoracis using thoracoscopy. These patients had both undergone closed intercostal drainage, but the drains had not worked effectually. We performed thoracoscopy under local anesthesia. Loculations were broken by the thoracoscopic instruments. After pleural irrigation, chest tubes were properly positioned under thoracoscopy. It seems likely that thoracoscopic procedures may be useful in shortening the length of hospitalization and in improving lung re-expansion of acute empyema thoracis patients.
Acute Disease↗
Tracheobronchomegaly accompanied by bilateral giant pulmonary bullae and left spontaneous pneumothorax. Case report.
A 58-year-old man with tracheobronchomegaly underwent simultaneous bilateral pulmonary surgery via median sternotomy for left spontaneous pneumothorax with bilateral giant bullae. Postoperative hypoxaemia and pneumonia necessitated ventilator and antibiotic treatment. Simultaneous bilateral pulmonary operations in patients with tracheobronchomegaly carry a risk of respiratory complications.
Humans↗
[Fibrosing mediastinitis, sclerosing mediastinitis].
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Diagnosis, Differential↗
[Two cases of pericardial rupture due to blunt chest trauma].
We treated two cases of pericardial rupture from blunt chest trauma. Case 1: A 55-year-old male was injured in an automobile accident. He recovered from the left hemothorax by tube drainage. One year and two months after the trauma, a left pericardial rupture was found during an operation for a left diaphragmatic hernia. As the epicardium adhered firmly to the pericardium, the ruptured pericardium was not sutured. Case 2: A 46-year-old man fell from a tree five meters in height. Chest radiography showed multiple right rib fractures, a pelvic fracture, pneumopericardium, and right hemopneumothorax. After four days, we performed a thoracoscopic examination under local anesthesia. The thoracoscopy revealed a rupture as large as an egg in the right pericardium anterior to the phrenic nerve. Judging from the size of the rupture, cardiac luxation was suspected not to have occurred. So the defect was not repaired. These two patients were discharged uneventfully without cardiac luxation. In the future, the accumulation of thoracoscopic findings may provide adequate information for judging the indication of operative repair in pericardial ruptures.
Humans↗
[Therapy of stage IV thymoma].
The clinical and pathological features of three patients with stage IV thymoma were presented. These patients were classified into stage IV at the first admission according to pericardial dissemination, mediastinal lymph node metastasis, and lung metastasis, respectively. One patient was accompanied with myasthenia gravis. All three patients underwent operations for primary thymoma. The metastatic lesions were also resected as completely as possible. Although postoperative radiotherapy was employed with all patients at the first therapy, chemotherapy was administered to 2 cases. After the first therapy, two patients had pleural dissemination and bilateral multiple lung metastases. They underwent second operations for pleural dissemination and metastatic lung tumors, and postoperative chemotherapy was performed. All three patients are alive (ranged, 2 years 6 months to 4 years 4 months postoperatively). Although follow-up of these three patients is short-term, it seems likely that radiotherapy and chemotherapy following surgery are effective treatments for patients with stage IV thymoma.
Aged↗
[Thoracoscopic resection of pleural tumor].
A thoracoscopic operation was safely performed for a case of a intrathoracic tumor. The patient was a 68-year-old male who had been treated for bronchial asthma and recurrent pneumonia. The reason for a successful operation were one-lung-ventilation under general anesthesia, the thoracoscopic electrocautery, the thoracoscopic ultrasonic surgical aspiration system, and thoracoscopic hemoclips. Pathologically the tumor was a benign mesothelioma. The patient was discharged without complications. In the treatment of intrathoracic benign diseases, thoracoscopic surgery is thought to be particularly useful to patients who are at high-risk in conventional thoracic operations due to accompanying respiratory diseases, as well as to patients requiring incisions as small as possible.
Aged↗
[A case of mediastinal cavernous hemangioma].
A case of mediastinal cavernous hemangioma was reported. An asymptomatic 6-year-old girl was discovered to have a mass in the left anterior superior mediastinum on a routine chest x-ray film. Computed tomograms demonstrated a mediastinal mass with calcification. Under a median sternotomy, a 10 x 9 x 5 cm mass was resected after dissecting the connections to the pericardium. As the mass surrounded the left phrenic nerve, the nerve was resected with the tumor. The histopathology was cavernous hemangioma. The calcification was not found in the vessels as the phleboliths but was showed in the interstitial tissues.
Calcinosis↗
[A case report of invasive thymoma presenting as a solitary metastatic lesion of the lung].
A 66-year-old woman visited our hospital for further investigation of a coin-shaped lesion in the right lower lung field. After admission, CT-scan revealed an anterior mediastinal tumor. Thymoma and lung metastasis from thymoma were suspected. At thoracotomy, an invasive thymoma involving the left phrenic nerve, the left upper lobe, and the pericardium was found, and the diagnosis of lung metastasis was made. Postoperative pathological findings showed a predominantly lymphocytic thymoma with round and oval-shaped epithelial cells, and the metastatic lung lesion revealed the same findings. Postoperative radiotherapy (4000 rads) and chemotherapy with a combination of CDDP, VDS, and CPA were administered. The metastasis of thymoma is not rare, but most often it is found after operation. In this case the diagnosis of metastatic thymoma was made pre-operatively from a solitary lung lesion.
Aged↗
[A case of pure red cell aplasia appearing after thymectomy].
We present a case of pure red cell aplasia appearing four months after thymectomy for an invasive thymoma. A 61-year-old female whose chest X-ray demonstrated an anterior mediastinal mass was admitted to our hospital. Preoperative examination revealed neither anemia nor myasthenia gravis. During surgery, as it was found that the thymoma had invaded the upper left lobe of the lung and the left diaphragmatic nerve, these tissues were partially resected along with the thymus and the parathymic adipose tissue. Histologically the epithelial cells of the thymoma had round-oval nuclei with predominant lymphatic infiltration. There were some clusters of epithelial cells in the adjacent involuted thymic tissues. After postoperative radiotherapy of 40 Gy, the patient was discharged. About four months after the operation, she was readmitted because of anemia. Bone marrow aspiration demonstrated few erythroblasts but normal findings of granulopoiesis. Chest CT and radioisotopic examination revealed neither metastases nor recurrence of thymoma. Her anemia showed marked improvement by steroid therapy. After she was discharged, her condition has been uneventful in spite of tapering the steroid dose for seven months.
Female↗
[A case of pneumothorax in a patient with costal exostosis].
A 21-year-old male was admitted to our hospital complaining of chest pain. He had undergone operations on multiple exostoses of his lower extremities when he was thirteen and fifteen years old. Family history revealed multiple exostoses in his mother and one of his cousins. Chest roentgenograms showed right pneumothorax and a mass arising from the seventh rib in the right lower lung filed. Chest CT revealed that the mass was located in thorax but outside the lung. These findings suggested that the pneumothorax was secondary to the injury of the right lung caused by an exostosis arising from the rib. Upon operation, we found a laceration of the lower lobe and a hard mass the size of a pea protruding from the seventh rib. A small bony spicule was also found to be projecting from the sixth rib. The hard mass and the spicule were resected with a normal portion of the seventh and the sixth ribs. The pathological findings of these bony lesion proved to be consistent with exostosis. The patient's postoperative course was uneventful. This case of pneumothorax caused by an exostosis lacerating the lung is rare.
Adult↗
[Reconstruction of anterior chest wall defect with ceramic bone grafts--a case of localized malignant mesothelioma].
The reconstruction of an anterior chest wall defect was performed on a 61-year-old male after resecting a localized malignant mesothelioma. The tumor was resected with body of the sternum, the anterior portion of the bilateral second, third and fourth ribs, muscles, subcutaneous tissue and skin. The defect was 12.5 cm x 9.5 cm in size. The reconstruction of the defect was made with Marlex mesh, two ceramic bone grafts and a latissimus dorsi musculocutaneous flap. Double Marlex mesh was sewn under the edges of the ribs and the intercostal muscles of the defect by interrupted sutures. In order to fit the ceramic bone graft to the defect transversely, two pieces of ceramic bones (Iliac crest spacers) were selected from various sizes. They were connected by a stainless steel wire through the holes which were originally made at the edge for fixation, and the connected portion was covered with methyl methacrylate. Two ceramic bone grafts were fixed to each of the stumps of the bilateral third and fourth ribs by monofilament threads. A musculocutaneous pedicle flap made from the right latissimus dorsi covered the operative filed. There were no postoperative wound infection and no extrusion of the prostheses seven months after the operation.
Biocompatible Materials↗
Leiomyoblastoma of the jejunum.
A 35-year-old male with the symptoms of acute abdomen proved to have a jejunal leiomyoblastoma. We renew recommendations for treatment by wide excision and regional lymphadenectomy.
Abdomen, Acute↗
[A case of thyroid carcinoma required the incision of the thyroid cartilage for inserting the silicone T tube after extensive tracheal resection and reconstruction].
A 57-year-old female with thyroid carcinoma, who had developed tracheal stenosis, underwent extensive tracheal resection and reconstruction. After the tracheal sleeve resection 5.2 cm in length, primary tracheal reconstruction was performed. Although complication did not occur at the anastomotic site, the patient had dyspnea due to cord dysfunction by bilateral recurrent nerve paralysis. After 20 days transnasal intubation we reoperated to perform a tracheostomy under neck incision. But the reconstructed trachea was too short to pull out from the mediastinum. In order to insert the silicone T tube, the incision of thyroid cartilage must be done and vocal cords were injured. The patient inserting the T tube through the laryngeal stoma had no dyspnea and no aspiration about two years after the operation in spite of palliative operation. It seemed likely that the trouble that tracheostomy could not be done would occur in some patients who had undergone extensive tracheal resection and reconstruction. But the insertion of silicone T tube through the laryngeal stoma provided a satisfactory result for airway problem.
Adenocarcinoma, Papillary↗