scholarly journals Bilateral Pneumothorax Associated With Lung and Pleural Metastases of Breast Cancer

2001 ◽  
Vol 7 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Terumasa Kurihara ◽  
Osamu Kawashima ◽  
Keiichi Endo ◽  
Yuichi Iino ◽  
Susumu Ishikawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Metastases ◽  
Thoracoscopic Surgery ◽  
Left Lung ◽  
Lower Lobe ◽  
Bilateral Pneumothorax ◽  
Stapling Device ◽  
Surgical Closure ◽  
Air Leaks ◽  
Pleural Metastases

A rare case of bilateral pneumothorax in a 54-year-old woman with advanced breast cancer associated with lung and pleural metastases is presented. The patient was admitted to our hospital complaining of unexpected severe dyspnea. A chest X-ray showed bilateral pneumothorax associated with multiple lung metastases and pleural effusions, followed by immediate pleural drainage. Although air leak and effusions of the right lung were well controlled by the conservative management, massive air leaks of the left lung had continued for 40 days. Because of patient's poor general status a surgical closure of the leaking site was selected using video-assisted thoracoscopic surgery techniques. Thoracoscopy revealed a ruptured bulla in the lower lobe (S6), thus, followed by a successful bullectomy with a stapling device. We speculate that multiple pleural metastasis may disturb the normal repair mechanism of the lung tissue and cause prolonged persistent air leaks.

scholarly journals A Case of Pulmonary Metastasis of Breast Cancer 23 Years after Surgery Accompanied with Non-Tuberculous Mycobacterium Infection

2020 ◽  
Vol 13 (3) ◽  
pp. 1357-1363
Author(s):  
Yuki Yabuuchi ◽  
Takayuki Nakagawa ◽  
Masaki Shimanouchi ◽  
Shingo Usui ◽  
Kenji Hayashihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Wedge Resection ◽  
Left Lung ◽  
Lower Lobe ◽  
Left Lower Lobe ◽  
Mycobacterium Infection ◽  
Er Positive ◽  
Positive Breast Cancer

Recurrence of oestrogen receptor (ER)-positive breast cancer rarely occurs postoperatively after a long period. Breast cancer cells survive and settle in distant organs in a dormant state, a phenomenon known as “tumour dormancy.” Here, we present a 66-year-old woman with recurrence of ER-positive breast cancer in the left lung 23 years after surgery accompanied with non-tuberculous mycobacterium infection (NTM). At the age of 43 years, the patient underwent a right mastectomy and adjuvant hormonotherapy to completely cure breast cancer. Twenty-three years after the operation, when the patient was 66 years old, computed tomography presented nodular shadows in the lower lobes bilaterally with bronchiectasis and ill-defined satellite tree-in-bud nodules. <i>Mycobacterium intracellulare</i> was detected in cultured bronchoalveolar lavage fluid obtained from the left lower lobe by bronchoscopy. Rifampicin, ethambutol, and clarithromycin were started, which resulted in shrinkage of the nodule in the right lower lobe and satellite nodules; however, the nodule in the left lower lobe increased in size gradually. Wedge resection of the left lower lobe containing the nodule by video-assisted thoracoscopic surgery was performed, which demonstrated that the nodule was adenocarcinoma in intraoperative pathological diagnosis; therefore, a left lower lobectomy and mediastinal lymph node dissection were performed. The tumour was revealed to be consistent with recurrence of previous breast cancer according to its morphology and immunohistochemical staining. Furthermore, caseous epithelioid cell granulomas existed in the periphery of the tumour. It is reported that inflammatory cytokines induce reawakening of dormant oestrogen-dependent breast cancer and, in our case, NTM infection might have stimulated the dormant tumour cells in the lower lobe.

scholarly journals CYSTIC PULMONARY HAMARTOMA MANIFESTING AS SPONTANEOUS PNEUMOTHORAX

2021 ◽  
Vol 29 (5) ◽  
pp. 624-628
Author(s):  
S.A. Plaksin ◽  
Keyword(s):  
Chest Pain ◽  
Histological Examination ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Left Lung ◽  
Lower Lobe ◽  
Shortness Of Breath ◽  
Lung Cysts ◽  
Pulmonary Hamartoma ◽  
Cystic Hamartoma

Cystic hamartoma refers to rare benign lung tumors. The literature describes 17 cases of this disease. The tumor may look like multiple bilateral cysts or a solitary single-chamber or multi-chamber cyst of a large size, which makes it difficult to diagnose. The disease can be complicated by spontaneous pneumothorax. The cyst itself often looks like a pneumothorax. An observation of a 52-year-old man complaining of chest pain and shortness of breath is presents. On the x-ray, the left lung is compressed with air, which is regarded as a spontaneous pneumothorax. Two-day drainage did not give any results. The video-assisted thoracoscopic surgery technique was performed and a large air cyst was detected. A conversion to a thoracotomy was made. A cyst of 20×15 cm size originated from the lower lobe, the lung was in atelectasis. Cyst resection and lung decortication were performed. Histological examination of the cyst wall revealed a hamartoma of the lung. The postoperative period was uneventful. Differential diagnosis of cystic hamartoma is conducting with lymphangioleiomyomatosis, air cysts, extrapulmonary sequestration, echinococcal cysts, and lung cancer. Indications for surgery are the following: chest pain, shortness of breath, pneumothorax, and hemoptysis. In a unilateral process, a cyst resection or lobectomy have to be performed. Cystic pulmonary hamartoma should be included in the differential diagnostic range in patients with recurrent spontaneous pneumothorax, hemoptysis, single and multiple lung cysts. It is impossible to determine the diagnosis without a biopsy and histological examination.

Butterfly-Needle Video-Assisted Thoracoscopic Segmentectomy

2009 ◽  
Vol 4 (6) ◽  
pp. 326-330 ◽  
Author(s):  
Mitsuhiro Kamiyoshihara ◽  
Seiichi Kakegawa ◽  
Takashi Ibe ◽  
Izumi Takeyoshi
Keyword(s):  
Thoracoscopic Surgery ◽  
Lower Lobe ◽  
Posterior Segment ◽  
Intercostal Space ◽  
Stapling Device ◽  
Video Assisted ◽  
Butterfly Needle ◽  
Intersegmental Plane ◽  
The Right ◽  
Made In

Objective A pulmonary segmentectomy is requires the identification of the segmental planes, making it technically more difficult than a lobectomy. Therefore, we present a new method that uses a butterfly needle to distinguish the intersegmental plane under video-assisted thoracoscopic surgery (VATS). Methods From May 2005 to August 2008, 15 patients underwent anatomic segmentectomy using VATS. In this approach, a working port 4 to 7 cm in length was made in the fifth intercostal space. Additional 1.2-cm thoracic ports were made in the seventh intercostal space on the anterior axillary line and the ninth intercostal space on the posterior axillary line. Each segment was selectively isolated, and the targeted bronchovascular pedicle was divided. For the segmentectomy, the lung was deflated, and the pulmonary artery and vein to the involved segment were divided. The segmental bronchus was divided using a stapling device. Using a butterfly needle, oxygen/air (1–2 L) was used to inflate the involved segment, and the involved segment was severed and removed using electrocautery or a stapling device. The raw surface was covered with an absorbable sealing material such as polyglycolic acid to prevent air leaks. Results Using this method, apical segment of the right upper lobe (S1), apical posterior segment of the left upper lobe (S1 + 2), upper division, and posterior segment of the right upper lobe (S2), superior segment of the right or left lower lobe (S6), and basal segmentectomies could be performed with VATS. However, the technique did not work in one patient with severe emphysematous changes, because the plane was not readily identifiable. Conclusions Butterfly-needle video-assisted segmentectomy is a useful technique. Selective segmental inflation allows the intersegmental plane to be identified completely under the surgeon's control, eliminating the need for an anesthesiologist to pass a bronchoscope or insufflate the lung in a particular manner.

scholarly journals Clinical observation of fatal bilateral spontaneous pneumothorax in wegener granulomatosis, which simulated lung cancer

2018 ◽  
Vol 9 (2) ◽  
pp. 42-49
Author(s):  
N. B. Khaydukova ◽  
Yu. A. Khabarov ◽  
V. A. Stepanov ◽  
E. A. Zvyezdkhina ◽  
Yu. V. Ivanov
Keyword(s):  
Spontaneous Pneumothorax ◽  
Clinical Observation ◽  
Left Lung ◽  
Lower Lobe ◽  
Malignant Neoplasm ◽  
Chronic Obstructive ◽  
Bilateral Pneumothorax ◽  
Wegener Granulomatosis ◽  
Obstructive Pulmonary Disease ◽  
The Right

We present a clinical observation of a 77 year-old patient admitted to the hospital with a sharp deterioration in the course of chronic obstructive pulmonary disease. The results of computed tomography of the chest read in favor of a newly detected malignant neoplasm of the upper lobe of the right lung with invasion into the mediastinum and secondary disseminations in the lower lobe of the left lung and liver. The performed fiber-optic bronchoscopy with a transbronchial lung biopsy did not verify the cancer diagnosis. The patient developed a bilateral spontaneous pneumothorax with the formation of bilateral bronchial-pleural fistulae with a massive air discharge through the pleural drainage. The presence of bilateral large bronchopleural fistulae did not allow a surgical intervention which required a separate intubation of the main bronchi. Minimally invasive techniques were ineffective. The patient died on the third day from the moment of the bilateral pneumothorax development due to severe respiratory failure. The autopsy established the diagnosis of Wegener’s granulomatosis affecting the lungs and kidneys.

scholarly journals Nasal intubation with bronchial blocker in a patient with difficult airway for thoracoscopic surgery

2021 ◽  
Vol 9 (2) ◽  
pp. 629
Author(s):  
Deepak C. Koli ◽  
Aditi P. Kadakia ◽  
Prajakta D. Latkar ◽  
Hemant H. Mehta
Keyword(s):  
Case Report ◽  
Difficult Airway ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Left Lung ◽  
Mouth Opening ◽  
Lower Lobe ◽  
Bronchial Blocker ◽  
Fiberoptic Intubation ◽  
Open Approach

We describe a case report of a 49 years old male, a case of Carcinoma tongue with one finger mouth opening operated multiple times, currently presented with pleural based soft tissue lesion in lower lobe of left lung with query metastasis posted for video assisted thoracoscopy surgery (VATS) SOS open thoracotomy and wedge resection of the lesion. Considering difficult airway due to restricted mouth opening we opted for an awake nasal fiberoptic intubation followed by general anaesthesia. One lung ventilation was achieved with CoopdechTM bronchial blocker type A with standard cuff size in left main stem bronchus. Postoperative course of patient was uneventful. In this case report we highlight the importance of use of fiberoptic bronchoscope and bronchial blocker for lung deflation in the management of difficult airway in VATS, as incomplete deflation of the nondependent lung during VATS can lead to poor surgical exposure and inadequate space for surgical manipulation which in turn can compromise the success of the procedure, and may possibly lead to conversion into an open approach.

scholarly journals En bloc transdiaphragmatic lung resection for locally advanced hepatocellular carcinoma: a case report

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Kit-fai Lee ◽  
Randolph H L Wong ◽  
Howard H W Leung ◽  
Eugene Y J Lo ◽  
Charing C N Chong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Locally Advanced ◽  
Left Lung ◽  
Lower Lobe ◽  
Uneventful Recovery ◽  
Advanced Hepatocellular Carcinoma ◽  
Right Hepatectomy ◽  
En Bloc ◽  
Liver Recurrence ◽  
Lung Base

Abstract A 56-year-old man presented with an 11-cm hepatocellular carcinoma (HCC) at segment 7 of liver. To induce left liver hypertrophy, a sequential transarterial chemoembolization (TACE) and portal vein embolization before right hepatectomy were adopted. However, the tumor further increased in size despite TACE and invaded through the diaphragm to the right lung base. Anterior approach right hepatectomy with en bloc wedge resection of the involved right lower lobe of lung by endovascular staplers via transdiaphragmatic approach was performed. The diaphragmatic defect was closed with Goretex mesh. Patient made an uneventful recovery. Pathology confirmed a 12.5 cm poorly differentiated HCC invading through diaphragm to lung. During follow-up, patient developed a 6 cm recurrence at left lung base 17 months after surgery for which he received sorafenib therapy. However, the lung mass further increased in size with new liver recurrence at segment 3 despite treatment. He succumbed 2 years and 3 months after surgery.

scholarly journals Breast Cancer Cell Re-Dissemination from Lung Metastases—A Mechanism for Enhancing Metastatic Burden

2021 ◽  
Vol 10 (11) ◽  
pp. 2340
Author(s):  
Lucia Borriello ◽  
John Condeelis ◽  
David Entenberg ◽  
Maja H. Oktay
Keyword(s):  
Breast Cancer ◽  
Cancer Cells ◽  
Cancer Cell ◽  
Metastatic Disease ◽  
Breast Cancer Cells ◽  
Lung Metastases ◽  
Primary Tumors ◽  
Metastatic Burden ◽  
First Time ◽  
Do So

Although metastatic disease is the primary cause of mortality in cancer patients, the mechanisms leading to overwhelming metastatic burden are still incompletely understood. Metastases are the endpoint of a series of multi-step events involving cancer cell intravasation, dissemination to distant organs, and outgrowth to metastatic colonies. Here we show, for the first-time, that breast cancer cells do not solely disseminate to distant organs from primary tumors and metastatic nodules in the lymph nodes, but also do so from lung metastases. Thus, our findings indicate that metastatic dissemination could continue even after the removal of the primary tumor. Provided that the re-disseminated cancer cells initiate growth upon arrival to distant sites, cancer cell re-dissemination from metastatic foci could be one of the crucial mechanisms leading to overt metastases and patient demise. Therefore, the development of new therapeutic strategies to block cancer cell re-dissemination would be crucial to improving survival of patients with metastatic disease.

scholarly journals Iron-Bound Lipocalin-2 from Tumor-Associated Macrophages Drives Breast Cancer Progression Independent of Ferroportin

Metabolites ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 180
Author(s):  
Christina Mertens ◽  
Matthias Schnetz ◽  
Claudia Rehwald ◽  
Stephan Grein ◽  
Eiman Elwakeel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Progression ◽  
Tumor Cells ◽  
Cancer Progression ◽  
Lung Metastases ◽  
Expression Profiles ◽  
The Cancer Genome Atlas ◽  
Lipocalin 2 ◽  
Tumor Associated Macrophages

Macrophages supply iron to the breast tumor microenvironment by enforced secretion of lipocalin-2 (Lcn-2)-bound iron as well as the increased expression of the iron exporter ferroportin (FPN). We aimed at identifying the contribution of each pathway in supplying iron for the growing tumor, thereby fostering tumor progression. Analyzing the expression profiles of Lcn-2 and FPN using the spontaneous polyoma-middle-T oncogene (PyMT) breast cancer model as well as mining publicly available TCGA (The Cancer Genome Atlas) and GEO Series(GSE) datasets from the Gene Expression Omnibus database (GEO), we found no association between tumor parameters and Lcn-2 or FPN. However, stromal/macrophage-expression of Lcn-2 correlated with tumor onset, lung metastases, and recurrence, whereas FPN did not. While the total iron amount in wildtype and Lcn-2−/− PyMT tumors showed no difference, we observed that tumor-associated macrophages from Lcn-2−/− compared to wildtype tumors stored more iron. In contrast, Lcn-2−/− tumor cells accumulated less iron than their wildtype counterparts, translating into a low migratory and proliferative capacity of Lcn-2−/− tumor cells in a 3D tumor spheroid model in vitro. Our data suggest a pivotal role of Lcn-2 in tumor iron-management, affecting tumor growth. This study underscores the role of iron for tumor progression and the need for a better understanding of iron-targeted therapy approaches.

Esophagus-Like Bronchus: A Noncommunicating Bronchopulmonary Foregut Malformation

2021 ◽  
pp. 106689692110022
Author(s):  
Jenny L. Weon ◽  
Stephen Megison ◽  
Charles F. Timmons ◽  
Dinesh Rakheja
Keyword(s):  
Left Lung ◽  
Lower Lobe ◽  
Tracheobronchial Tree ◽  
Pulmonary Infections ◽  
Bronchopulmonary Foregut Malformation ◽  
Radiologic Examination ◽  
Foregut Malformation

We describe a previously unreported bronchopulmonary foregut malformation wherein a segment of a bronchus of the lower lobe of the left lung in a 4-year-old girl was entirely esophageal in structure. No communication was identified between the tracheobronchial tree and the esophagus by radiologic examination or at surgery. The esophagus-like bronchus was associated with an adjacent atretic bronchus and a downstream cavity in the lower lobe of the left lung. The child sought clinical attention because of recurrent pulmonary infections localized to the lower lobe of the lung. We posit that this esophagus-like bronchus is a novel noncommunicating bronchopulmonary foregut malformation.

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