RESUMO
We present an unusual case of a 72-year-old patient with a concurrent aortic arch pseudoaneurysm and right diaphragmatic hernia, who was successfully treated using an aortic endovascular stent and diaphragmatic repair via uniportal video-assisted thoracoscopic surgery.
Assuntos
Falso Aneurisma/cirurgia , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Procedimentos Endovasculares/métodos , Hérnia Diafragmática Traumática/cirurgia , Traumatismos Torácicos/complicações , Cirurgia Torácica Vídeoassistida/métodos , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/lesões , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/etiologia , Hérnia Diafragmática Traumática/diagnóstico , Hérnia Diafragmática Traumática/etiologia , Humanos , Masculino , Traumatismos Torácicos/diagnóstico , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/diagnósticoRESUMO
Invasive mucinous adenocarcinoma (IMA) is an uncommon entity in the lung, with a poor prognosis. Multifocal IMA of the lung is even more unusual, and there is little experience with effective treatments. Herein, we present a case of multifocal IMA diagnosed in a 36 year-old man by video-assisted thoracoscopic surgery. A right middle lobe and a nodule in the right upper lobe were resected, as were mediastinal lymph nodes, leaving behind an autonomous right lower lobe nodule. To explore the feasibility of molecular treatment, next-generation sequencing of genetic mutations was performed after four cycles of chemotherapy (pemetrexed + cisplatin). Ultimately, a KIAA1468-RET fusion gene was detected at a disproportionate level (~67.3%), indicating that targeted therapy may be efficacious in treating this disease.