Author of

• 25972

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  P3.CR - Case Reports (Not CME Accredited Session) (ID 984)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 2
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27841

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    P3.CR-24 - Surgical Resection of 30 Years’ Recurring Pneumonia: 1 Case of Giant Bronchopulmonary Sequestration (ID 13729)

    12:00 - 13:30  |  Author(s): Xueshan Qiu
    • Abstract

    Background
    

    Bronchopulmonary sequestration is easily omitted or missed diagnosed as recurrent pulmonary infection or pneumonia due to having no specific symptoms. Recurring pulmonary infection is the most common manifestation for bronchopulmonary sequestration. Enhanced CT is useful for diagnosis by revealing clearly the aberrant vessel from aorta to the sequestered mass. Surgery is of the best choice for treatment. Here we report one rare case of giant tumor-like bronchopulmonary sequestration, with three aberrant thicker vessels from descending aorta to the sequestered mass.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    A male aged 38 in Nov 2017, with recurring pneumonia, breath with difficulty, fatigue for more than 30 years, until recently enhanced CT revealed three aberrant thicker vessels from descending aorta connecting to the 20x15x12cm3 giant solid tumor-like mass in left lower-lobe suggested the possibility of pulmonary sequestration. Heart and lung function test showed normal; there was no contraindication for surgery. Surgical resection became first of choice.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Standard posterolateral thoracotomy was performed, and severe adhesion closed the thoracic cavity. The normal pulmonary fissure was not existed. Whole left lower lobe became a 20x15x12cm3 solid giant tumor-like mass, with sever inflammatory edema on pulmonary surface, rich lateral wall circulation between the lung and chest wall. Three aberrant thicker vessels 2.5, 1.5, 1.2cm in width were found from descending aorta connecting into the left lower lobe, confirming the diagnosis of bronchopulmonary sequestration. Severe adhesion prevented separating left lower-lobe from diaphragm. Left lower pulmonary vein was first separated, ligated and cut; left lower-lobe bronchus, left lower-lobe arteries branches were then separated, ligated and cut. The widest one of the three aberrant thicker vessels was almost as same as the descending aorta in width. Three vessels were 2.5, 1.5, 1.2cm in width were separated, ligated and then cut, respectively. The patient recovered rapidly. Six months’ follow-up revealed that the patient recovered better than before, pneumonia, dyspnea, and fatigue were all completely disappeared.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Bronchopulmonary sequestration is less common and easily omitted or missed diagnosed as recurrent pulmonary infection. Bronchopulmonary sequestration with three aberrant thicker and larger vessels was rare. Enhanced CT is useful for diagnosis. Once diagnosed, surgery is of the best choice for treatment. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05, 17-230-9-71)

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  • 27857

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    P3.CR-37 - Extensive Resection for Invasive Atypical Carcinoid of Thymus: 1 Case Report (ID 13717)

    12:00 - 13:30  |  Author(s): Xueshan Qiu
    • Abstract

    Background
    

    Atypical carcinoid of thymus (ACT) is extremely rare. Patients with ACT usually have no specific symptoms, and mostly are found as mediastinal tumors when taking chest X-ray or CT scanning. ACT is usually aggressive and extensive surgical resection is of first choice, even though chemo-radiation is recommended but showing less effects. Here we report one case of ACT invading adjacent organs and tissues received extensive radically surgical resection.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    A male aged 53 in Mar 2018, with chest distress, fatigue for 1 month; chest CT revealed a round 5x4x3cm3 mediastinal tumor sitting on superior vena cava, aortic arch. Thymoma was diagnosed. Heart and lung function test showed normal; there was no contraindication for surgery. Surgical resection became first of choice.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Median sternotomy was performed, and the 5x4x3cm3 tumor was confirmed invading into adjacent superior vena cava and left innominate vein, invading aortic adventitia, pericardium, right mediastinal pleural and right upper lobe of the lung. Extensive and radical en block resection was performed including resection and followed plasty of the lateral wall of the superior vena cava and right innominate vein, resection of being-invaded aortic adventitia, pericardium, right mediastinal pleural, right upper lobe of the lung, and resection of the whole thymoma and fat tissues of thymus body and four feet. The surgical resection was evaluated as perfect, being resected completely and radically. Postoperative adjuvant radiation was followed one month later. No chemotherapy was added. The patient is now recovering rapidly and healthily. Long term follow-up is needed to monitor recurrence and metastasis.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Atypical carcinoid of thymus is extremely rare. Surgical resection is of first choice. Complete en bloc resection of the whole tumor, the whole fat tissues of thymus body and four feet, and adjacent being-invaded organs and tissues, is the key point to avoid recurrence, to cure ACT. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05, 17-230-9-71)

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