Case Report: En Bloc Resection of Pancoast Tumor with Adjuvant Aortic Endograft and Chemoradiation (original) (raw)
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Clinical Techniques in Small Animal Practice, 1998
Thoracic surgical oncology involves surgical treatment of lesions of the thoracic wall, pulmonary parenchyma, or mediastinum (also including heart, esophagus, or trachea). The most common neoplasms of the thoracic wall are osteosarcoma and chondrosarcoma. Histopatholog~c type, the use of chemotherapy for osteosarcoma, and completeness of surgical margins are prognostm for survival. Relative to sohtary pulmonary masses, carcinomas are most common, with histopathologm type, tumor size, tumor grade, and lymph node status prognostic for survival. Of the aforementioned variables, lymph node status is the most significant. Extensive preoperative workup, including bronchoscopy and transthoraclc fine needle aspiration of solitary lung masses, is usually not recommended. Thymomas are the most common surgical medlastinal mass. Patients are frequently affected with paraneoplastic syndromes including myasthenla gravis, polymyositis, and nonthymic neoplasia. Patients w~thout megaesophagus with surgically resectable masses have an excellent prognosis for survival. Provision of analgesia after surgery in thoracotomy patients is extremely important. Carefully selected analgesic agents in thoracotomy patients are far less damaging to cardiovascular status than is tachycardia from excessive pain. Given these and other guidelines, perioperative mortality in thoracotomy patients is minimal, and long-term survival m selected patients is excellent. Copynght © 1998 by W.B. Saunders Company M asses of the thoracic wall, mediastinum, and lung parenchyma each represent a different collection of clinical signs, appropriate diagnostic tests, surgical treatment, and prognosis. An understanding of respiratory and circulatory physiology, behavior of common neoplastic conditions, surgical anatomy of the thorax, and postoperative care of thoracotomy patients is imperative in the treatment of neoplastic conditions of the thorax. Thoracic Wall Signalment and clinical s,gns. Masses of the thoracic wall most commonly involve the ribs, but can also occur in the sternum. The median age ranges from 6.71 to 9 2 years, and there is no sex predilection. Large breed dogs are overrepresented) The most common clinical sign is a visible growing mass on the thoracic wall. They most frequently occur on the seventh rib and at the costal-chondral junction. 3 Both right-sided 4 and left-sided I predominance have been reported. Other clinical signs include weight loss, lethargy, lameness
Extensive Resections: Pancoast Tumors, Chest Wall Resections, En Bloc Vascular Resections
Surgical Oncology Clinics of North America, 2011
Infiltration by lung tumor of adjacent anatomic structures including major vessels (pulmonary artery [PA], superior vena cava [SVC], aorta, and supra-aortic vessels), main bronchi, and chest wall not only influences the oncologic severity of the disease but also increases the technical complexity of surgery, requiring extended resections and demanding reconstructive procedures. Completeness of resection represents in every case one of the main factors influencing the long-term outcome of patients.
Pancoast tumors: characteristics and preoperative assessment
Journal of thoracic disease, 2014
Superior sulcus tumors (SSTs), or as otherwise known Pancoast tumors, make up a clinically unique and challenging subset of non-small cell carcinoma of the lung (NSCLC). Although the outcome of patients with this disease has traditionally been poor, recent developments have contributed to a significant improvement in prognosis of SST patients. The combination of severe and unrelenting shoulder and arm pain along the distribution of the eighth cervical and first and second thoracic nerve trunks, Horner's syndrome (ptosis, miosis, and anhidrosis) and atrophy of the intrinsic hand muscles comprises a clinical entity named as "Pancoast-Tobias syndrome". Apart NSCLC, other lesions may, although less frequently, result in Pancoast syndrome. In the current review we will present the main characteristics of the disease and focus on the preoperative assessment.
A 71-yr-old male with increasing dyspnoea, cough and an intrathoracic mass
European Respiratory Journal, 2003
A 71-year-old White male was referred to the Martini Hospital for evaluation of progressive shortness of breath, tiredness, a nonproductive cough and night sweats. Until the beginning of his complaints a few weeks before, he felt healthy and skated 40 km per week. His appetite was good, he had not lost weight, had no skin or joint disorders and no thoracic pain.