1/46. Subcutaneous seeding after ultrasound-guided placement of intrapleural catheter. An unusual complication of the intracavitary palliative treatment of pleural mesothelioma.Intrapleural catheters are useful in the palliative treatment of malignant effusions. Complications are infrequent and of little importance. We report a case of subcutaneous implantation metastasis along the course of intrapleural catheter, which had been placed under sonographic guidance in a patient with pleural mesothelioma. After drainage of the effusion, cisplatin plus cytarabine was administered via the chest tube, achieving complete remission of the pleural effusion. Subcutaneous metastasis became evident 3 months later and was the only sign of disease progression for 2 months. The seeding of cancer cells was probably caused by a small leakage of fluid around the chest tube that occurred during the placement procedure as a result of the increased intrapleural pressure caused by the large quantity of fluid that had accumulated in the pleural space.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/46. Needle-tract implantation from hepatocellular cancer: is needle biopsy of the liver always necessary?Percutaneous needle biopsies are frequently used to evaluate focal lesions of the liver. Needle-tract implantation of hepatocellular cancer has been described in case reports, but the true risk for this problem has not been clearly defined. We retrospectively reviewed 91 cases of hepatocellular cancer during a 4-year period from 1994 to 1997. Data on diagnostic studies, therapy, and outcome were noted. Of 91 patients with hepatocellular cancer, 59 patients underwent percutaneous needle biopsy as part of their diagnostic workup for a liver mass. Three patients (5.1%) were identified with needle-tract implantation of tumor. Two patients required en bloc chest wall resections for implantation of hepatocellular cancer in the soft tissues and rib area. The third patient, who also received percutaneous ethanol injection of his tumor, required a thoracotomy and lung resection for implanted hepatocellular cancer. Percutaneous needle biopsy of suspicious hepatic lesions should not be performed indiscriminately because there is a significant risk for needle-tract implantation. These biopsies should be reserved for those lesions in which no definitive surgical intervention is planned and pathological confirmation is necessary for a nonsurgical therapy.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
3/46. Chest wall implantation of a mediastinal liposarcoma after thoracoscopy.We report a case of mediastinal liposarcoma resected by thoracoscopy. Despite the precautionary measures, chest wall implantations occurred rapidly at the port's sites in the chest wall and led to death within 24 months. We conclude that thoracoscopy is not a good approach for resection of anterior mediastinal masses in view of their possible malignant character.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
4/46. lung cancer implantation in the chest wall following percutaneous fine needle aspiration biopsy.We describe a 70-year-old man with lung cancer implantation in the chest wall following percutaneous fine needle aspiration biopsy. He underwent lobectomy after percutaneous transthoracic fine needle aspiration biopsy using a 19-gauge needle. Twenty-six months after the biopsy, he noticed a hard subcutaneous tumor at the biopsy site in the chest wall. ribs and intercostal muscles were resected. The primary lung tumor and the chest wall tumor were histologically identical, but were not contiguous to each other. We concluded that the subcutaneous tumor was due to needle biopsy implantation. This complication is extremely rare, but open biopsy should always be considered as a possible alternative. During the procedure, care must be taken with the least chance of implantation and patients should be observed carefully after needle biopsy.- - - - - - - - - - ranking = 3.5keywords = chest (Clic here for more details about this article) |
5/46. Pleuroperitoneal shunts and tumor seeding.A 76-year-old man with malignant mesothelioma of the left pleura was referred for surgical palliation. He was dyspneic at rest and had anterior chest pain and a persistent cough. Chest x-ray film revealed an extensive left pleural effusion. A thoracoscopy was performed, and 3L of pleural fluid was drained. Both the pleural surfaces and rhe diaphragm were studded with tumors. On maximal inflation of the lung, the parietal and visceral pleura did not oppose, and therefore a Denver shunt was inserted. At 6 weeks follow-up, the shunt was performing satisfactorily. At follow-up 9 weeks postoperatively, the subcutaneous tunnel was infiltrated by mesothelioma over a distance of some 15 cm.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
6/46. Surgical removal of a distinct subcutaneous metastasis of multilocular hepatocellular carcinoma 2 months after initial percutaneous ethanol injection therapy.Subcutaneous tumor seeding after percutaneous ethanol injection therapy (PEI) for hepatocellular carcinoma is a rarely seen complication. It is reported due to needle track seeding during PEI after a distance of 6-46 months. Metastatic tumor spread is described subcutaneously, to the chest wall, abdominal wall and diaphragm. We report the case of a 76-year-old patient with chronic hepatitis b infection and cirrhosis which let to a multilocular hepatocellular carcinoma who underwent PEI. This patient developed 2 months after primary PEI a subcutaneous tumor formation confined to the right lower chest wall. Surgical tumor resection was performed. The histopathological evaluation confirmed subcutaneous seeding of the preknown hepatocellular carcinoma with a maximum of 30 mm in diameter. As a risk of PEI subcutaneous metastasis of the primary tumor should be considered even in early stage of therapy and close follow-up of the patient during treatment is required. Surgical tumor resection to ensure the curative intention of PEI is advisable.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
7/46. Implantation metastasis caused by fine needle aspiration biopsy following curative resection of stage IB non-small cell lung cancer.Fine needle aspiration is a useful procedure in the diagnosis of lung cancer, however controversy still remains as to whether it should be employed particularly in patients with operable lung cancer. We report herein a case of metastatic tumor at the site of transthoracic needle biopsy following a curative resection in a patient with stage IB bronchogenic carcinoma. The patient was managed with aggressive chest wall resection and subsequent musculocutaneus flap transposition, however he died 11 months after the initial operation. The tumor implantation risk and the related complications should be considered in patients with operable bronchogenic carcinoma undergoing a tranthoracic needle aspiration biopsy.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
8/46. Port site metastasis of ovarian carcinoma remote from laparoscopic surgery for benign disease.BACKGROUND: The use of laparoscopic surgical procedures has continued to expand due to the many advantages that this surgical approach offers. However, as we continue to realize the benefits and expand the scope of laparoscopic procedures, new complications may occur. CASE: This is the case of a 77-year-old gravida 2 para 2 who underwent exploratory laparotomy and surgical staging with optimal cytoreduction for Stage IIIC papillary serous ovarian carcinoma in February 1998. Her past surgical history was significant for total abdominal hysterectomy and left salpingo-oophorectomy in 1955 for symptomatic leiomyomata and for a laparoscopic cholecystectomy in July 1997. After initial platinum-based chemotherapy, she presented with an enlarging nodule at the right upper quadrant laparoscopic port site. Fine needle aspiration confirmed recurrent papillary serous ovarian carcinoma. After a discussion of her options, she elected to undergo surgical resection with postoperative salvage chemotherapy. CONCLUSION: Port site recurrences have been previously reported in patients who underwent initial surgical evaluation for ovarian carcinoma utilizing the laparoscopic approach. However, it is unusual for recurrent cancer to appear in port sites or operative incisions not related to the initial cancer surgery. This report serves to caution the gynecologic oncologist that the first evidence of recurrence may be at a laparoscopic port site from prior benign gynecologic or nongynecologic surgery.- - - - - - - - - - ranking = 0.048409347039137keywords = upper (Clic here for more details about this article) |
9/46. Implantation of oral squamous cell carcinoma at the site of a percutaneous endoscopic gastrostomy: a case report.A 55-year-old man had an operation and radiotherapy for a squamous cell carcinoma of the oral cavity and developed a metastatic deposit at the site of a percutaneous endoscopic gastrostomy, with no other evidence of systemic spread. Treatment of the metastasis was by neo-adjuvant chemotherapy with cisplatin and 5-fluorouracil (5-FU) followed by en bloc resection of the stomal recurrence on the anterior abdominal wall. There has been no evidence of recurrence to date. Only 17 other cases of metastasis to this site from a primary tumour in the upper aerodigestive tract have been reported. We review the relevant publications and discuss the techniques, complications and possible mechanisms of spread and their implications for the use of percutaneous endoscopic gastrostomy in head and neck cancer surgery.- - - - - - - - - - ranking = 0.048409347039137keywords = upper (Clic here for more details about this article) |
10/46. Transcatheter arterial embolization and extrabeam radiation therapy for subcutaneous seeding of hepatocellular carcinoma by percutaneous ethanol injection.A 74-year-old man with a hepatocellular carcinoma received percutaneous ethanol injection twice following the needle biopsy of the tumor. Two years and 6 months after percutaneous ethanol injection, a subcutaneous tumor, which appeared to be a needle tract seeding by percutaneous ethanol injection, was recognized in the right lower anterior chest wall. A curative surgical resection was impossible because of the patient's decreased coagulopathy and severe liver dysfunction. The disseminated tumor was treated with extrabeam radiotherapy (20 fractions; total dose of 50 grays) followed by transcatheter arterial embolization by means of superselective catherization. The size of the subcutaneous tumor was decreased to about 15 mm in diameter. Contrast medium enhanced computed tomography demonstrated no enhancement in the tumor. The patient is currently doing well without further recurrence of hepatocellular carcinoma and without enlargement of the subcutaneous tumor after extrabeam radiation therapy and transcatheter arterial embolization.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
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