Paraganglioma intrapericárdico asociado a la presencia de mutación en el gen de la enzima succinato deshidrogenasa / Intrapericardical paraganglioma associated with mutation in succinate dehydrogenase enzyme gene

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Resection of metastatic pulmonary lesion of ossifying fibromyxoid tumor extending into the left atrium and ventricle via pulmonary vein.

The ossifying fibromyxoid tumor (OFMT) of soft parts is a rare soft tissue neoplasm of uncertain lineage. The most common metastases are found in the lung. Herein, we present the first case report of pulmonary metastasis of ossifying fibromyxoid tumor with intracardiac extension, which was resected carefully using cardiopulmonary bypass and cardiac arrest. Subsequently pulmonary left lower lobectomy was performed. The patient recovered uneventfully and was discharged in after a few days. Recently, OFMT has been considered as a tumor of intermediate malignancy. We recommend wide surgical excision of primary tumor and radiotherapy. Early follow-up is mandatory.

Tratamiento de las perforaciones hipofaríngeas y del esófago cervical. Papel del abordaje conservador / Treatment of the perforations of the hypopharynx and the cervical oesophagus. Role of the conservative management

Objetivo: Las perforaciones de la hipofaringe y del esófagocervical son hechos graves e infrecuentes que, incluso,pueden poner en peligro la vida del paciente. El otorrinolaringólogo,en función del área anatómica en que desarrollasus funciones, debe conocer bien esta patología.Material y métodos: Revisamos diez casos de perforacionesintraluminales de la hipofaringe o el esófago cervical,tratados en nuestro servicio entre los años 1.999 y 2003.Resultados: Los cuerpos extraños fueron la causa principalde perforación. En cuatro casos el tratamiento fuequirúrgico y en los seis restantes empleamos un tratamientoconservador. En algunos casos la morbilidad fueimportante pero no hubo mortalidad.Conclusiones: El tratamiento de las perforaciones a estenivel debe ser individualizado y multidisciplinario. El diagnósticoprecoz es un factor pronóstico importante. Losavances en la terapéutica antibiótica y nutricional, juntocon el cumplimiento de las indicaciones, permiten quecada vez podamos utilizar con mayor frecuencia y máséxito los tratamientos conservadores

Background:Perforations of the hypopharynx and the cervicaloesophagus are severe infrequent situations whichmay even be life-threatening for patients. Theotorhinolaryngologist must be aware of this situation.Material and methods: We review ten cases ofintraluminal perforations of the hypopharynx or cervicaloesophagus, treated at our department between 1999and 2003.Results: Foreign bodies were the main cause ofperforation. In four cases, the treatment was surgical,and in the other six cases, conservative treatment wasapplied. In some cases, the morbidity was considerablebut there were no mortalities.Conclusions: The treatment of perforations at this level mustbe individualized and multidisciplinary. The early diagnosisof these perforations is an important factor for prognosis.Advances in antibiotic and nutritional therapies andobservance of the indications, made possible a more frequentand successfully use of a conservative therapeutic approach

Type of resection and prognosis in lung cancer. Experience of a multicentre study.

OBJECTIVE: Analysis of prognosis of the different types of resections for lung cancer defined by the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S). METHODS: From October 1993 to September 1997, 2994 patients with bronchogenic carcinoma who underwent thoracotomy were prospectively recruited by the GCCB-S. Prior to recruitment, the GCCB-S had defined two types of non-resectional operations (diagnostic and exploratory thoracotomies) and three types of resections (complete-CR-: free resection margins, mediastinal nodal dissection, no extracapsular nodal involvement, no involvement of most distant removed nodes; relatively incomplete-RIR-: free resection margins, no mediastinal nodal dissection, unremoved nodes, involvement of most distant removed nodes, positive pleural effusion with no pleural implants; and incomplete-IR-: positive resection margins, extracapsular nodal involvement, unremoved positive nodes, positive pleural effusion with pleural implants). For survival analyses, patients with small cell carcinoma, induction therapy, postoperative mortality, unclassified operation, or lost to follow-up were excluded. The total number of evaluable patients was 2543. RESULTS: In 1047 (97%) patients, RIR was defined because they had undergone a lesser nodal evaluation than mediastinal nodal dissection. Five-year survival and 95% confidence interval were: diagnostic thoracotomy 11% (0-30%), exploratory thoracotomy 5% (1-9%), IR 20% (14-26%), RIR 43% (39-47%), and CR 45% (41-49%). Differences between IR and CR or RIR were statistically significant (P<0.0001), but those between CR and RIR were not (P=0.18). CONCLUSIONS: CR and RIR should be combined in a single category as complete resection, because they do not discriminate prognostic differences.

Management of hypopharyngeal and cervical oesophageal perforations.

BACKGROUND: Perforations of the hypopharynx and the cervical oesophagus are infrequent severe situations, which may even be life-threatening for patients. METHODS: We review seven cases of intraluminal perforations of the hypopharynx or cervical oesophagus treated at our department between 1999 and 2001. RESULTS: In this series of patients, foreign bodies were the main cause of perforation. In four cases, the treatment was surgical by means of a cervicotomy and/or thoracotomy and drainage; in the other three cases, conservative treatment was applied. In some cases, the morbidity was considerable but there were no mortalities. CONCLUSIONS: The treatment of perforations of the hypopharynx and the cervical oesophagus must be individualized and multidisciplinary. The early diagnosis of these perforations is an important factor for prognosis.