1/716. paraplegia after thoracotomy--not caused by the epidural catheter.BACKGROUND: paraplegia and peripheral nerve injuries may arise after general anaesthesia from many causes but are easily ascribed to central block if the latter has been used. CASE REPORT: A 56-yr-old woman, with Bechterev disease but otherwise healthy, was operated with left-sided thoracotomy to remove a tumour in the left lower lobe. She had an epidural catheter inserted in the mid-thoracic area before general anaesthesia was started. bupivacaine 0.5% 5 ml was injected once and the infusion of bupivacaine 0.1% with 2 micrograms/ml fentanyl and 2 micrograms/ml adrenaline (5 ml/h) started at the end of surgery. The patient woke up with total paralysis in the lower limb and sensory analgesia at the level of T8, which remained unchanged at several observations. laminectomy, performed 17 h after the primary operation, showed a large piece of a haemostatic sponge (Surgicel) compressing the spinal cord, which was then decompressed but the motor and sensory deficit remained virtually unchanged both then and a year later. CONCLUSIONS: This case shows--once again--that although central blocks may cause serious neurological complications and paraplegia, other causes are possible and have to be considered. However, all patients with an epidural catheter must be monitored for early signs and symptoms of an intraspinal process and the appropriate treatment has to be instituted instantly.- - - - - - - - - - ranking = 1keywords = tumour (Clic here for more details about this article) |
2/716. Bronchioloalveolar carcinoma with metastasis to the pituitary gland: a case report.An unusual case of metastatic bronchioloalveolar carcinoma of the lung presented as a pituitary tumour in a young adult Chinese female, who subsequently died after having undergone trans-sphenoidal resection. Metastatic cancers of the pituitary are uncommon even in necropsy series and rarely give rise to clinical symptoms. This case draws attention to the fact that, although uncommon, pituitary metastases have been noted with increasing frequency and their distinction from primary pituitary tumours is often difficult. A metastatic pituitary tumour may be the initial presentation of an unknown primary malignancy, wherein the metastatic deposits may also be limited to the pituitary gland. Clinicians and pathologists alike should consider a metastatic lesion in the differential diagnosis of a non-functioning pituitary tumour.- - - - - - - - - - ranking = 4keywords = tumour (Clic here for more details about this article) |
3/716. pulmonary blastoma: a report of two cases and a review of the literature.pulmonary blastoma is the rarest malignant tumour of the lung. Two more cases are reported and the literature is reviewed. The first case, a woman, is the longest recorded survivor. An examination of all the reported cases shows that the tumour is less common and less agressive in women.- - - - - - - - - - ranking = 2keywords = tumour (Clic here for more details about this article) |
4/716. Flitting radiographic shadows: an unusual presentation of cancer in the lungs.Tumour involvement of pulmonary blood vessels occurs frequently in advanced lung cancer and occasionally may cause pulmonary infarction. A case is reported of diffuse obstruction of pulmonary arteries by cancer in which no primary tumour was found, and which presented as flitting radiographic opacities due to pulmonary infarction.- - - - - - - - - - ranking = 1keywords = tumour (Clic here for more details about this article) |
5/716. Primary synovial sarcoma of the lung: report of two cases confirmed by molecular detection of SYT-SSX fusion gene transcripts.AIMS: Primary pulmonary sarcoma is rare, and frequently creates diagnostic challenges. We describe two cases of primary pulmonary spindle cell sarcoma in which a molecular approach using archival paraffin-embedded tissue was proved to aid diagnosis. methods AND RESULTS: Both patients had huge masses replacing the upper and middle lobes of the lung, respectively, without any primary extrapulmonary neoplastic lesions. Microscopically, the lesions showed a solid hypercellular nodular or lobular growth of atypical short spindle cells in variably intersecting fascicles or in a haphazard fashion, together with focal areas displaying a prominent haemangiopericytoma-like pattern. Immunohistochemically, a small number of the tumour cells were positive for epithelial markers such as cytokeratin and epithelial membrane antigen. In both cases, a reverse transcription-polymerase chain reaction using rna extracted from formalin-fixed, paraffin-embedded tissues detected SYT-SSX fusion gene transcripts, which are characteristic of synovial sarcoma. CONCLUSION: On the basis of the morphological and molecular findings, these tumours are considered to be rare examples of monophasic synovial sarcoma of the lung. Our molecular assay detecting the SYT-SSX fusion transcripts is useful for the final diagnosis of synovial sarcoma arising at such an unusual anatomical site.- - - - - - - - - - ranking = 2keywords = tumour (Clic here for more details about this article) |
6/716. Spontaneous regression of large-cell carcinoma of the lung--a rare observation in clinical practice.Spontaneous regression of non-small-cell lung carcinoma is extremely rare and there are few documented cases. We report a 59-year-old man with a right upper lobe tumour which showed progressive regression while hilar adenopathy appeared 2 months after the initial tumour detection. At operation, only scar tissue was found in the lung but a hilar lymph node contained large-cell undifferentiated carcinoma. This report indicates that a decrease in size of a pulmonary mass does not exclude the diagnosis of carcinoma and that metastatic disease can occur even if the primary tumour regresses.- - - - - - - - - - ranking = 3keywords = tumour (Clic here for more details about this article) |
7/716. Primary pulmonary meningioma presenting as lung metastasis.A benign primary pulmonary meningioma, an extremely rare tumour, was incidentally detected in a 57-year-old woman in association with a contralateral pulmonary adenocarcinoma. The meningioma was initially suspected to be a metastasis. Both tumours were excised, with excellent outcome. Anatomic features of primary pulmonary meningioma and differential diagnosis are discussed.- - - - - - - - - - ranking = 2keywords = tumour (Clic here for more details about this article) |
8/716. Acute neoplastic arterial embolism after pneumonectomy.Intra-arterial tumour embolism after pneumonectomy is a known but rare complication. It arises because of tumour involvement of pulmonary veins. Usual outcome of this complication is grave when embolism is to a major vessel. If embolism occurs in a peripheral circulation, timely intervention can avoid significant morbidity. We report a case where embolisation occurred in both the femoral arteries. Emergency embolectomy was done successfully avoiding major complication.- - - - - - - - - - ranking = 2keywords = tumour (Clic here for more details about this article) |
9/716. Primary cancer of the larynx associated with primary lung cancer. Report of 21 cases, 14 with autopsy findings and 7 biopsies.The present paper reports 21 cases (14 autopsies and 7 biopsies) of associated primary cancers of the larynx and the lung. This association is by no means uncommon, the laryngeal lesion being usually the first to appear. Mulitple primary cancers--of the same or of a different histologic type--tend to occur in the same organ or organ system, either simultaneously or after a time interval. In case of synchronous primary malignant tumour of the larynx and lung the most lethal cancer (the lung cancer) must be managed first. Cancer patients are more likely than other individuals to develop a second primary malignant tumour. Laryngectomized patients should be followed-up possibly by means of cytologic examinations of bronchial secretions and chest x-rays at short intervals for early detection of a possible second primary malignant pulmonary lesion.- - - - - - - - - - ranking = 2keywords = tumour (Clic here for more details about this article) |
10/716. Primary pulmonary malignant meningioma.Fewer than 20 cases of primary pulmonary meningioma have been reported. Most of these cases have been histologically and clinically benign. We report an unusual case of primary pulmonary malignant meningioma with atypical histologic features and malignant behavior. A computed tomography scan of the head did not show evidence of tumor. The right upper lobe mass was resected and showed features of an atypical meningioma with loss of architectural pattern, mild nuclear pleomorphism, increased mitotic counts (up to 15 mitotic figures per 10 high power fields), and focally prominent nucleoli. Focally, cells with rhabdoid features were identified. The tumor's immunohistochemical and ultrastructural profiles were consistent with a meningioma. The tumor stained negative for estrogen and focally positive for progesterone receptors and had a MIB-1 labeling index (marker of cell proliferation) of 9.2%. Approximately 5 months after the initial resection, the patient experienced a tumor recurrence with multiple lymph node metastases, spread to the middle and lower lobes of the right lung, and metastasis to the diaphragm. Rarely, primary pulmonary meningiomas may present as high-grade malignant lesions.- - - - - - - - - - ranking = 0.22061940365609keywords = rhabdoid (Clic here for more details about this article) |
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