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113P SARCOMA OF LUNG, PLEURA
Lung Cancer 80 Suppl. 1 (2013) S49–S51 Contents lists available at SciVerse ScienceDirect
Lung Cancer journal homepage: www.elsevier.com/locate/lungcan
RARE THORACIC TUMOURS 113P SARCOMA OF LUNG, PLEURA Y. Voloshyn Thoracic Surgery, State Institution “National Institute of Psychiatry and Pulmonology named after F.G. Yanovsky of National Academy of Medical Science of Ukraine”, Kyiv, Ukraine Aim: To study clinical features and diagnosis of sarcoma, malignant tumor developed in intermediate subpleural or pleural tissue of lung. 62 cases of sarcoma of Methods: Retrospective analysis lung (55), pleura (7), treated in the Institute over the last 45 (72.58%), women 17 (27.42%), age of 18 years. Men majority 40 70 years. Before clinic 19 were treated mistakenly and unsuccessfully (1 3 months) for: pneumonia 11, infiltrative 4, intercostal neuralgia 4. Complaints: pain tuberculosis 58, increase of body temperature on the side of lesion (38.2 40ºC) 51, dispnea 39, loss of weight 32, cough 25, weakness 60, hemoptysis 9. Clinical phenomena quickly grew. X-rays: formation in right (43), left (19) lung, in limits of upper (37), lower (25) lobe round intensive homogenous shadow with clear 12. uneven contour (diameter 4 15 cm), atelectasis of lobe Analysis of blood: anemia, blood sedimentation rate increased 18 72 mm, fibrinogen 7.5 37.5 mmol/l 48, dysproteinemia 37, immunologically reactivity decreased. Oncotest of “blood drop”, worked out in the Institute positive in 19 of 24. Results: Clinic-roentgenologic and laboratory data: quick growth of formation and clinical symptoms led to suspicion of sarcoma in 38 patients. Transthoracic punctio of formation, brash biopsy with urgent cyto-histologic study of bioptates (24). Atypical cells 58. Preoperative preparation. Under endotracheal anesthesia: wide lobectomy 21, bilobectomy 7, pneumonectomy 26, explorative 8. Morphologically: fibrosarcoma of bronchus 3, thoracotomy sarcoma 47, leukomyosarcoma 5, sarcoma of pleura 7. After operation anti-inflammatory, symptomatic, pathogenetic therapy. Complications 12. 3 died of thromboembolia of lung artery. Clinical effect 59 (95.16%). 17 lived from 1.5 to 2 years and 11 patients 2 3 years of 28. Conclusions: Sarcoma of lungs and pleura is more often seen in men aged 40 70 years. Quick growth of clinical symptoms: pains on the side of lesion, high blood temperature, loss of weight, dispnea, weakness. Roentgen: big intensive formation in lung with uneven clear contour, with its quick growth let suspect sarcoma. Instrumental methods of examination with cyto-histologic study, oncotest of “blood drop” are important in diagnosis. Timely diagnosis, complex therapy, surgical treatment may prolong lives. Disclosure: All authors have declared no conflicts of interest.
0169-5002 /$
see front matter
114P SURGICAL TREATMENT OF ADENOCYSTIC CANCER OF THE TRACHEA N.V. Mosina1 , I.V. Mosin2 , O.V. Lukina3 Hospital Surgery, Pavlov’s State Medical University, Saint Petersburg, Russian Federation, 2 Hospital Therapy, Pavlov’s State Medical University, Saint Petersburg, Russian Federation, 3 Radiology, Pavlov’s State Medical University, Saint Petersburg, Russian Federation
1
The main treatment of patients with primary malignant tumors of the trachea is endoscopic recanalization of the trachea lumen with stenting and radiotherapy. Radical surgery of the adenocystic cancer is single-step circular resection with end-to-end anastomosis. The aim was to demonstrate that a single-step circular resection is possible when tumor extension is 45% of the trachea length, with involvement of the epiglottis subfold portion. In the period from 2003 2013, 15 single-step circular resections were performed in patients with adenocystic cancer of the trachea. The age of the patients was from 41 to 68 years (5 male, 10 women). Among them over 45% of trachea was resected in 12 patients. Localisation and extension of the tumor was established by fibrobronchoscopy, and MDCT. Tumor extension from 1.0 to 3.0 cm was diagnosed in 12 patients. Singlein 3 patients, and from 3.0 to 6.0 cm step circular resections and tracheotracheal anastomosis were performed in 5 patients, laryngotracheal anastomosis in 4, and a laryngotracheal resections were made in 6 patients. In all cases patients underwent radiotherapy. Immediate and prospective results of the treatment are considered to be sufficient in all patients. In Pearson-Grillo laryngotracheal resection the distance between the anastomosis and vocal cords varied from 1 cm to 3 cm. Single-step circular resection is the only radical surgical treatment of primary trachea malignancies. Subfold portion involvement is not a contraindication to a single-step circular resection of the trachea and subfolder portion of the epiglottis. Postoperatively, a singlestep circular resection for adenocystic cancer must be followed by radiotherapy. Disclosure: All authors have declared no conflicts of interest. 115P ORAL ETOPOSIDE IN PRETREATED ADVANCED THYMOMA AND THYMIC CARCINOMA. A FRENCH EXPERIENCE C. Boutros, F. Fayard, B. Besse Department of Medicine, Institut de Cancerologie Gustave Roussy, Villejuif, France Purpose: Thymomas and thymic carcinomas, also named thymic epithelial tumors (TET), are rare tumor entities. There is no standard systemic treatment for pretreated advanced, recurrent TET. Here, we review the efficacy and tolerability of oral etoposide in this setting. Patients and Methods: We reviewed the files of patients who were treated for TET in our institution from November 1992 through December 2012. Patients who received oral etoposide (25 mg 3 times a day, 3 weeks out of 4) for advanced recurrent disease
Lung Cancer journal homepage: www.elsevier.com/locate/lungcan
RARE THORACIC TUMOURS 113P SARCOMA OF LUNG, PLEURA Y. Voloshyn Thoracic Surgery, State Institution “National Institute of Psychiatry and Pulmonology named after F.G. Yanovsky of National Academy of Medical Science of Ukraine”, Kyiv, Ukraine Aim: To study clinical features and diagnosis of sarcoma, malignant tumor developed in intermediate subpleural or pleural tissue of lung. 62 cases of sarcoma of Methods: Retrospective analysis lung (55), pleura (7), treated in the Institute over the last 45 (72.58%), women 17 (27.42%), age of 18 years. Men majority 40 70 years. Before clinic 19 were treated mistakenly and unsuccessfully (1 3 months) for: pneumonia 11, infiltrative 4, intercostal neuralgia 4. Complaints: pain tuberculosis 58, increase of body temperature on the side of lesion (38.2 40ºC) 51, dispnea 39, loss of weight 32, cough 25, weakness 60, hemoptysis 9. Clinical phenomena quickly grew. X-rays: formation in right (43), left (19) lung, in limits of upper (37), lower (25) lobe round intensive homogenous shadow with clear 12. uneven contour (diameter 4 15 cm), atelectasis of lobe Analysis of blood: anemia, blood sedimentation rate increased 18 72 mm, fibrinogen 7.5 37.5 mmol/l 48, dysproteinemia 37, immunologically reactivity decreased. Oncotest of “blood drop”, worked out in the Institute positive in 19 of 24. Results: Clinic-roentgenologic and laboratory data: quick growth of formation and clinical symptoms led to suspicion of sarcoma in 38 patients. Transthoracic punctio of formation, brash biopsy with urgent cyto-histologic study of bioptates (24). Atypical cells 58. Preoperative preparation. Under endotracheal anesthesia: wide lobectomy 21, bilobectomy 7, pneumonectomy 26, explorative 8. Morphologically: fibrosarcoma of bronchus 3, thoracotomy sarcoma 47, leukomyosarcoma 5, sarcoma of pleura 7. After operation anti-inflammatory, symptomatic, pathogenetic therapy. Complications 12. 3 died of thromboembolia of lung artery. Clinical effect 59 (95.16%). 17 lived from 1.5 to 2 years and 11 patients 2 3 years of 28. Conclusions: Sarcoma of lungs and pleura is more often seen in men aged 40 70 years. Quick growth of clinical symptoms: pains on the side of lesion, high blood temperature, loss of weight, dispnea, weakness. Roentgen: big intensive formation in lung with uneven clear contour, with its quick growth let suspect sarcoma. Instrumental methods of examination with cyto-histologic study, oncotest of “blood drop” are important in diagnosis. Timely diagnosis, complex therapy, surgical treatment may prolong lives. Disclosure: All authors have declared no conflicts of interest.
0169-5002 /$
see front matter
114P SURGICAL TREATMENT OF ADENOCYSTIC CANCER OF THE TRACHEA N.V. Mosina1 , I.V. Mosin2 , O.V. Lukina3 Hospital Surgery, Pavlov’s State Medical University, Saint Petersburg, Russian Federation, 2 Hospital Therapy, Pavlov’s State Medical University, Saint Petersburg, Russian Federation, 3 Radiology, Pavlov’s State Medical University, Saint Petersburg, Russian Federation
1
The main treatment of patients with primary malignant tumors of the trachea is endoscopic recanalization of the trachea lumen with stenting and radiotherapy. Radical surgery of the adenocystic cancer is single-step circular resection with end-to-end anastomosis. The aim was to demonstrate that a single-step circular resection is possible when tumor extension is 45% of the trachea length, with involvement of the epiglottis subfold portion. In the period from 2003 2013, 15 single-step circular resections were performed in patients with adenocystic cancer of the trachea. The age of the patients was from 41 to 68 years (5 male, 10 women). Among them over 45% of trachea was resected in 12 patients. Localisation and extension of the tumor was established by fibrobronchoscopy, and MDCT. Tumor extension from 1.0 to 3.0 cm was diagnosed in 12 patients. Singlein 3 patients, and from 3.0 to 6.0 cm step circular resections and tracheotracheal anastomosis were performed in 5 patients, laryngotracheal anastomosis in 4, and a laryngotracheal resections were made in 6 patients. In all cases patients underwent radiotherapy. Immediate and prospective results of the treatment are considered to be sufficient in all patients. In Pearson-Grillo laryngotracheal resection the distance between the anastomosis and vocal cords varied from 1 cm to 3 cm. Single-step circular resection is the only radical surgical treatment of primary trachea malignancies. Subfold portion involvement is not a contraindication to a single-step circular resection of the trachea and subfolder portion of the epiglottis. Postoperatively, a singlestep circular resection for adenocystic cancer must be followed by radiotherapy. Disclosure: All authors have declared no conflicts of interest. 115P ORAL ETOPOSIDE IN PRETREATED ADVANCED THYMOMA AND THYMIC CARCINOMA. A FRENCH EXPERIENCE C. Boutros, F. Fayard, B. Besse Department of Medicine, Institut de Cancerologie Gustave Roussy, Villejuif, France Purpose: Thymomas and thymic carcinomas, also named thymic epithelial tumors (TET), are rare tumor entities. There is no standard systemic treatment for pretreated advanced, recurrent TET. Here, we review the efficacy and tolerability of oral etoposide in this setting. Patients and Methods: We reviewed the files of patients who were treated for TET in our institution from November 1992 through December 2012. Patients who received oral etoposide (25 mg 3 times a day, 3 weeks out of 4) for advanced recurrent disease