Thoracoscopic resection of a pulmonary lymphangioma: a case report

We report a extremely rare case of a 57-year-old man who was found to have a solitary tumor in the right middle lobe of his lung during an annual check-up. Chest X-ray and CT scan showed a well-circumscribed spherical mass adjacent to the chest wall. The tumor, which was removed by thoracoscopic surgery, was a cystic mass, 17 x 15 mm. Histological examination confirmed the diagnosis of a pulmonary lymphangioma. A brief review of the available literature on this extremely rare type of lung tumor follows the case report.     

Glomus Tumor in a Segmental Bronchus: A Case Report

Glomus tumors originate from a neuroarterial structure called the glomus body, and grow mostly in soft tissue. It is rare for glomus tumors to develop in the respiratory system. The patient of the present case had an abnormal shadow in the right lung on chest X-ray, and computed tomography (CT) findings displayed a lung tumor in the right S6. Bronchoscopy was performed for the diagnosis of the lung tumor, and a polypoid bronchial tumor was unexpectedly found to occupy the right B3. The bronchial tumor was diagnosed as a glomus tumor, and the lung tumor was diagnosed as an adenocarcinoma. The bronchial glomus tumor was cauterized by argon plasma coagulation (APC). Three weeks after the cauterization by APC, the right lower lobectomy was performed for the treatment of the lung adenocarcinoma. The patient has remained disease free for 2 years.     

A giant tumor of the thumb revealing bronchic adenocarcinoma (a case report)

Bone metastases in the hand are rare. The authors report a case of a 46-year-old woman diagnosed with a giant hand tumor, revealing a lung adenocarcinoma. An amputation of the thumb was performed. Histology confirmed a metastasis from the lung adenocarcinoma.     

Pulmonary adenofibroma in a middle-aged man: report of a case

We report a case of pulmonary adenofibroma, a rare benign soft-tissue tumor characterized by a combination of glandular and spindle stromal elements, in a 55-year-old man. This case is interesting because of the unusual X-ray and computed tomography (CT) imaging findings of a well-defined, subpleural soft-tissue nodule in the inferior lobe of the left lung, which showed no enhancement after contrast scan. The tumor was resected completely via video-assisted thoracoscopy. Microscopic and immunohistochemical examinations supported the diagnosis of a benign pulmonary adenofibroma. The patient remains well with no evidence of recurrence 16 months after surgery. Although the imaging findings were nonspecific, adenofibroma may be one of diagnostic inclusions of soft-tissue nodules of the lung in middle-aged patients.     

Benign metastasizing leiomyoma; report of a case

We report very rare case of benign mestasizing leiomyoma (BML). A 42-year-old female was referred to our hospital presenting with abnormal shadows revealed by a chest X-ray film. Chest computed tomography (CT) scan revealed multiple well-defined nodules in bilateral lung field, suggesting metastatic lung tumor. Further examination could not detect any suspicious primary lesion. Several tumor markers were all within normal limits. Surgical resection was performed to establish diagnosis and treatment. Pathological diagnosis was BML from the uterus myoma which had been resected 5 years before.     

Pleomorphic carcinoma of the lung; report of a case

Pleomorphic carcinoma is a rare primary lung cancer with a poor prognosis. We report a surgically treated case of pleomorphic carcinoma of the lung. An abnormal shadow was incidentally detected by computed tomography (CT) scan for an 80-year-old male. CT scan performed 1 month before the detection of tumor was normal. Right upper lobectomy with ND2a was performed after 5 months follow-up by CT scan because of the enlargement of the tumor. Histological examination showed numerous atypical spindle cells with massive necrosis, diagnosing as pleomorphic carcinoma. Only 2 months after operation, multiple metastases to the lung, chest wall, pleura, and small intestine were found.     

Intrarenal neuroblastoma with pulmonary metastases mimicking a Wilms tumor

Primary intrarenal neuroblastoma is extremely rare and is a mimic of Wilms tumor. We present a case of a renal mass in a 14 month old male with lung metastases at the initial presentation. This was thought to represent a Wilms tumor. Histology of a biopsied lung nodule revealed neuroblastoma.     

Multiple primary pulmonary meningiomas: 20-year follow-up findings for a first reported case confirming a benign biological nature

IntroductionPrimary pulmonary meningiomas (PPMs) are very rare neoplasms, and we reported the first multiple case of PPMs in 1998. Usually, PPMs are slow-growing tumors with a good prognosis. Herein, we reported a rare multiple case of PPMs with an extremely long clinical course.Presentation of the caseAn 84-year-old Japanese woman with a history of multiple PPMs histologically confirmed as having a right-sided slowly growing lung nodule for 20 years. In 2010, we also reported the additional clinical course in the initial case 10 years after surgery implying a benign biological nature. Subsequent to that report, new lesions appeared in the bilateral lung fields with quite a slow growth rate. She was asymptomatic, and no tumor was observed in the cranial cavity during the course of her disease.Discussion and conclusionThis case illustrates rare multiple PPMs and highlights their biological behavior with very slow progression from a most likely benign tumor over a 20-year period.     

Pulmonary mucinous cystadenocarcinoma: report of a case and review of the literature

A case of primary mucinous cystadenocarcinoma of the lung is presented. The patient was a 42-year-old woman with a 5-cm left lung mass. Left lower lobectomy was performed and analysis of a frozen section revealed mucinous cystadenocarcinoma. The tumor was a fibrous, walled cyst containing abundant mucinous material. Sparse groups of malignant cells were microscopically observed in pools of mucin; thus, the tumor resembled mucinous cystadenocarcinoma that occurs in the ovary, appendix, or pancreas. The tumor we found is a very rare intrapulmonary neoplasm that is differentiated from a metastatic lesion and mucinous bronchoalveolar carcinoma by its very different clinical course and prognosis.     

Invasive micropapillary carcinoma of the ascending colon--a report of a case

Micropapillary carcinoma (MC) has been recently recognized to be a rare but distinctive variant of adenocarcinoma. At present, only a limited number of colorectal MC cases have been reported. We present a case of MC of the ascending colon with distant metastasis. A 61-year-old female patient was hospitalized with a complaint of abdominal pain. A diagnostic work-up revealed cancer of the ascending colon with multiple lung metastases. The patient underwent a right hemicolectomy with lymph node dissection. A peritoneal nodule was observed in the abdominal cavity during surgery, and this nodule was also resected. The pathologic findings of the colon tumor revealed components of conventional tubular adenocarcinoma and micropapillary carcinoma. Lymph nodes and a peritoneal nodule revealed tubular adenocarcinoma. MC is a rare disease but has high malignant potential. In the present case the tumor was small in size, but the patient had a peritoneal and multiple lung metastases.     

Intrapulmonary localized fibrous tumor of the lung: a very unusual presentation

Most localized fibrous tumors arise from the visceral pleura on a stalk and project into the pleural cavity in a pedunculated manner. The origin of the tumors is now believed not to be mesothelial but rather submesothelial, based on studies using conventional histology, immunohistochemistry, and ultrastructural analysis. While inward tumor growth into the lung parenchyma with attachment to the pleura is uncommon, the tumor with an entirely pulmonary location is extremely rare. We present here a rare case of entirely intrapulmonary localized fibrous tumor (ie, localized fibrous tumor of the lung), and we review the pertinent literature.     

Adenocarcinoma of the lung in a young adult

We report a case of 24-year-old young man with lung adenocarcinoma. The patient had been treated malignant lymphoma when he was 5 years old. The patient was pointed out a tumor shadow of the right lung at his 2008 health check, but he did not receive further examination. He was again pointed out a same tumor at his 2009 health check. Plain chest computed tomography (CT) revealed a nodule in S8 of right lung. A diagnosis of lung adenocarcinoma was established by the cytology specimens obtained with bronchoscopic examination. The patient underwent right lower lobectomy with systematic lymph node dissection. Pathological stage was pT2N2M0 stage IIIA. Lung cancer patients aged under 30 years old are rare. Lung cancer should be considered even in young patients with abnormal chest shadows.     

Successful treatment of triple primary tumor

INTRODUCTIONThe occurrence of multiple primary tumors is rare. Only limited number of cases with triple malignancy have been reported. We report here a rare case of a woman presented synchronous triple tumors, in her lung, breast, skin.PRESENTATION OF CASEA 56-year-old woman presented with invasive ductal carcinoma of breast, non-small cell lung cancer and malignant melanoma. The patient undergone mastectomy and malignant melanoma tumor excision on-site. After operation stereotactic radiotherapy was given to her lung tumor. Six course of chemotherapy was given to her. She is alive with no progression.DISCUSSIONThe patient was diagnosed with melanoma and staging by FDG/PET. There is not any study about routine using PET/CT in the melanoma staging.CONCLUSIONThis is a very rare synchronous triple tumor case.     

Spindle cell carcinoma of the lung

We report a rare case of spindle cell carcinoma in the lung. A 73-year-old woman was admitted because of a lung tumor, which was indicated during a group examination. Chest computed tomography revealed a tumor located in the right lung accompanied by spiculation. Right upper lobectomy with lymph nodal dissection was performed. Histological findings revealed only spindle-shaped tumor cells, and immunohistochemical stain showed that they were cytokeratin-positive. We diagnosed it as a pulmonary spindle cell carcinoma.     

Bilateral adrenal metastasis as first clinical manifestation of pulmonary carcinoma: report of a case and review of the literature

Bilateral adrenal metastases are rare, and the first manifestation from non-small cell lung cancer is also exceptional. We report a case of bilateral adrenal metastases from a poorly differentiated lung adenocarcinoma in a 50 year-old-man. The treatment was local excision of tumor and the diagnosis was histological. We comment the clinical presentation, diagnosis, treatment and evolution of this case, with special attention to the histopathological analysis of this lesion and literature review.     

Giant-cell tumor of the patella with lung metastases: a case report

Giant-cell tumors are an infrequent clinical, radiological, and pathological entity observed in 5% of primary bone tumors. They generally occur at the epiphysis of long bones, particularly in the knee area but patellar localization seems very rare. Despite their perfectly benign histological aspect, giant-cell tumors may be aggressive, leading to local recurrence or even distant metastasis to the lung. We report a case of benign giant-cell tumor of the patella with lung metastasis observed in a 23-year-old woman. The aggressive radiological image was suggestive of chondrosarcoma. Histologically the differential diagnosis with chondroblastoma was difficult. The tumor and lung metastasis were treated by surgical resection. Four years later there has been no recurrence. We present the anatomic and clinical aspects of giant-cell tumor of the bone together with the diagnostic approach and the clinical course.     

Carcinosarcoma of the lung mis-diagnosed preoperatively as a mediastinal tumor

Carcinosarcoma of the lung is an uncommon tumor and is rarely preoperatively correctly diagnosed. The prognosis of patients with carcinosarcoma is extremely poor, despite treatment. A 79-year-old man was mis-diagnosed preoperatively as having a malignant mediastinal tumor. Excision of the tumor with segmentectomy of the lung revealed it was composed of a variety of carcinomatous and sarcomatous elements, which is a clear manifestation of the histogenetic totipotentiality of carcinosarcoma. He was subsequently treated with adjuvant chemotherapy and irradiation. He remains well at sixteen months after the operation, to date. Here we report this rare true case of a carcinosarcoma, focusing on the difficulty of a correct preoperative diagnosis.     

A case of thoracoscopic resection of a pulmonary infarction mimicking a metastatic lung tumor]

We report here a rare case of pulmonary infarction which was resected as a metastatic pulmonary tumor. A 57-year-old male patient referred for exhibiting an abnormal shadow on chest X-ray 8 months after the resection of invasive adrenal tumor. The patient underwent thoracoscopic resection of the lesion as a metastatic tumor. However, intraoperative pathological examination revealed that the resected specimen was pulmonary infarction. Post-operative MRI and ultrasound images showed no evidence of venous thrombus. Pulmonary infarction can exhibit an abnormal shadow in the lung fields, and it is necessary to be distinguished from true tumor.     

Carcinosarcoma of the lung mis-diagnosed preoperatively as a mediastinal tumor.

Carcinosarcoma of the lung is an uncommon tumor and is rarely preoperatively correctly diagnosed. The prognosis of patients with carcinosarcoma is extremely poor, despite treatment. A 79-year-old man was mis-diagnosed preoperatively as having a malignant mediastinal tumor. Excision of the tumor with segmentectomy of the lung revealed it was composed of a variety of carcinomatous and sarcomatous elements, which is a clear manifestation of the histogenetic totipotentiality of carcinosarcoma. He was subsequently treated with adjuvant chemotherapy and irradiation. He remains well at sixteen months after the operation, to date. Here we report this rare true case of a carcinosarcoma, focusing on the difficulty of a correct preoperative diagnosis.     

Pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma

INTRODUCTIONPrimary Pulmonary Mucinous Cystadenocarcinoma PPMC is an extremely rare subtype of pulmonary adenocarcinoma, with only a few dozen cases reported in the literature to date.PRESENTATION OF CASEWe report a extremely rare case of pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma. 53-year-old man exposed to asbestos, he is admitted in hospital with a 5 cm mass in right pleura. He was treated by wedge resection. Sparse groups of malignant cells were microscopically observed in pools of mucin. The postoperative histopathological findings were in accordance with the diagnosis of pulmonary mucinous cystadenocarcinoma on cystic adenoid malformation of lung. 5 years later, the patient has no recurrence.DISCUSSIONPPMC is usually asymptomatic; hemoptysis is seen occasionally. Preoperative diagnosis is very difficult to establish. Both FNA cytology and transbronchial lung biopsy seem inadequate. Our patient went on to undergo open lung biopsy and histopathological testing that confirmed the diagnosis of PMC.CONCLUSIONIt is important to differentiate this rare pathological feature of the lung from other lung tumors as the treatment is surgical rather than medical. Thoracic surgeons should bear in mind this rare tumor for the differential diagnosis of a pleural mesothelioma because this tumor has a favorable prognosis.