[Congenital Defect of the Pericardium Incidentally Found during Surgery for Lung Cancer:Report of a Case].

A 78-year-old man was admitted to our hospital for further examination of a mass shadow in the left lower lobe noted on chest computed tomography. Because lung cancer was suspected, a left lower lobectomy was performed. During surgery, the left lower lobe and heart were so tightly adherent that the pericardial defect was not initially perceivable. As we proceeded with adhesion detachment, we discovered that the left lower lobe and the myocardium were directly adherent to one another through a complete defect of the pericardium, which required very careful surgical technique. Because of the complete defect of the pericardium, we considered the risk of heart failure to be low and accordingly did not perform a repair. The postoperative course was uneventful.

[Outcomes of Sublobar Resection for the Patients with a Metachronous Multiple Lung Cancer].

OBJECTIVES: In order to perform appropriate treatment for metachronous multiple lung cancer, it is important to verify the surgical treatment outcome. We evaluated the surgical outcome of metachronous multiple lung cancer focused on the sublobar resection of metachronous second lung cancer. METHODS: The subjects of this study were 1,513 cases that underwent radical resection for primary lung cancer in our institution from January 2004 to April 2020. We selected 23 (1.5%) patients who underwent lobectomy for initial primary lung cancer and underwent sublobar resection for metachronous second lung cancer. RESULTS: The median follow-up period from resection for initial primary lung cancer to resection for metachronous second lung cancer was 49 months. Regarding the analyses for survival, the median follow-up period after resection for initial primary lung cancer was 79 months with a five-year overall survival rate of 80.4% and a five-year relapse-free survival rate of 75.6%. Whereas the median follow-up period after resection for metachronous second lung cancer was 27 months with a five-year overall survival rate of 55.8% and a five-year relapse-free survival rate was 48.4%. CONCLUSIONS: The long-term outcome for sublobar resection for metachronous second lung cancer was similar to previous reports and the rate of complications tended to be low.

[Mediastinal Dedifferentiated Liposarcoma Resected with Partial Resection of Pericardium].

An anterior mediastinal tumor was detected by computed tomography (CT) in a 66-year-old man who complained of left flank pain, and the surgical treatment was performed. At surgery, partial resection of the pericardium was also conducted because the pericardial inversion was suspected. The histopathological diagnosis was dedifferentiated liposarcoma. The patient is well without adjuvant chemotherapy 23 months after the surgery.

[Lung Abscess by Drug-resistant Pseudomonas Aeruginosa Necessary to Differentiate from Lung Cancer:Report of a Case].

A 64-year-old man visited our hospital because of an abnormal shadow on an annual health check-up. Chest computed tomography demonstrated a nodule 22 mm in size in the right lung. 18-F fluorodeoxyglucose positron emission tomography showed abnormal accumulation in the nodule. Since lung cancer was suspected, a right wedge resection was performed. Pathological examination showed no malignant findings in the nodule. The diagnosis of lung abscess by drug resistance Pseudomonas aeruginosa was made by the pus culture and the postoperative course was uneventful.

[Pneumothorax during Pazopanib Therapy in a Patient with Soft Tissue Sarcoma].

Pazopanib is an anti-angiogenic multi-targeted tyrosine kinase inhibitor used for treating soft tissue sarcomas and renal cell carcinoma. Although the occurrence of pneumothorax during pazopanib treatment has been recognized as an adverse event, there have been no reports of pneumothorax in patients treated with pazopanib. Here, we present the case of a 71- year-old male patient who developed pneumothorax during adjuvant pazopanib therapy after surgery for metastasized renal cell carcinoma. Left hilar and mediastinal lymph node swelling was detected in the postoperative surveillance after surgery, and radiological findings showed lymph node metastasis from renal cell carcinoma. Consequently, left upper lobectomy and mediastinal lymph node dissection were performed, and subsequent pathological examination confirmed the aforementioned diagnosis. Pazopanib was administered as an adjuvant therapy. However, the patient developed left pneumothorax on day 101. Although chest tube drainage was performed, massive air leak continued. A surgery was performed to repair the persistent air leak. This case demonstrates that pneumothorax should be recognized as an adverse event of pazopanib.

[Aspergillus Empyema with Bronchopleural Fistula due to Destroyed Lung after Postoperative Radiotherapy for Thymoma].

A 35-year-old man underwent adjuvant chemoradiation therapy to the surgical margin of the thymoma. Five years after the therapy, an area of the right upper lung lobe, which was included in the irradiation field, developed destroyed lung, resulting in Aspergillus empyema with bronchopleural fistula. To control the infection, an open window thoracostomy was performed. As the bronchopleural fistula resulted in pneumonia, bronchial embolization was performed with an Endobronchial Watanabe Spigot. After the empyema cavity was cleaned, the empyema space was closed with omental and muscular flap, thoracoplasty. Negative pressure wound therapy was carried out because of poor wound healing. The patient is doing well without relapse 15 months after the thoracoplasty.

[Giant Intrathoracic Goiter Requiring Emergency Airway Management;Report of a Case].

An 81-year-old woman with acute respiratory distress was referred to our hospital. Computed tomography showed a large mass in the upper mediastinum with severe tracheal stenosis. Endotracheal intubation was performed under the preparation of extracorporeal membrane oxygenation and high-frequency jet ventilation, and the tumor was completely removed. The pathologic diagnosis was a goiter. Post-operatively, respiratory distress disappeared. No tumor recurrences have been noted for more than 2 years after surgery.