Female and male differences in the survival of patients undergoing resection for lung cancer.

OBJECTIVE: In recent years much attention has been focused on the rapidly increasing incidence of primary lung cancer in women. The aim of this study was to determine gender differences in patients treated surgically for lung cancer. METHODS: We performed a retrospective review of patients who had lung resection for primary lung cancer from January 1994 to December 1998. RESULTS: There were 530 men and 42 women. Women were younger than men (55.6 +/- 10 versus 57 +/- 9.9). The difference was not statistically significant (p = 0.9). The mean cigarette consumption was greater in men than in women (p < 0.001). We observed a higher operative morbidity and mortality rate in men compared to women (p < 0.05). Men had more squamous cell carcinoma (61.7%). In female patients, squamous cell cancer and adenocarcinoma were found with almost the same incidence (35.7% versus 33.3%). There was a significant difference in the distribution of cell types (p < 0.001). Pathologic stages for women were; I = 38.2%, II = 21.4%, IIIa = 21.4%, IIIb = 9.5%, IV = 9.5% and for men; I = 40.4%, II = 26.6%, IIIa = 24%, IIIb = 6%, IV = 3%. There was no significant difference in the stage distribution between genders (p = 0.2). Median survival for female and male patients were 38 +/- 9.2 and 35 +/- 3.2 months. Female patients' survival was longer than male patients but the difference was not statistically significant (p > 0.05). CONCLUSIONS: This study emphasizes sex differences in cigarette consumption, operative mortality and the distribution of cell types of patients with primary lung cancer. These initial results should strongly encourage additional studies in different countries on the interaction between sex and lung cancer characteristics to improve clarity.

Primary malignant melanoma of the lung in oculocutaneous albino patient.

Oculocutaneous albinism is a rare autosomal recessive disorder characterized by general depigmentation, nystagmus, photophobia, and decreased visual acuity. Malignant melanoma is extremely rare in patients with albinism. We present a 41-year-old albino male patient, who was admitted with a suspected bronchogenic carcinoma. He underwent a pulmonary resection and the diagnosis was primary malign melanoma of the lung. The patient died of tumor recurrence in the postoperative 46th month.

Atypically located pericardial cysts.

Pericardial cysts are uncommon benign abnormalities and are most often found in either cardiophrenic angle. We present the cases of 3 patients with a cyst in the mediastinum and review the literature. Pathological examination confirmed the diagnosis of pericardial cyst. Clinicians should include pericardial cyst in the differential diagnosis of mediastinal masses.

Fibrohistiocytic tumor of the trachea in a child.

A 10-year-old girl who had been treated for presumed asthma during the previous year, was admitted to our hospital with dyspnea and wheezing. An endotracheal tumor was detected and a tracheal resection was performed. The tumor was diagnosed as a fibrohistiocytic tumor. Biologic behavior of fibrohistiocytic tumors of the trachea is not clear and morphologically similar cases are interpreted as malignant or benign by different authors. However, an analysis of the present case and 11 well documented cases in the literature shows that this tumor must be evaluated as a low-grade malignancy and initial complete tumor resection is necessary.

Chest wall echinococcosis.

The chest wall is an uncommon localization for hydatid cyst. In this article, six patients were operated on because of chest wall hydatid cysts between the years 1989 to 1991 have been reported. Four of them had previously undergone surgery for pulmonary or hepatic hydatidosis; the chest wall was the primary site in two patients. Operative procedures for chest wall echinococcosis were cystectomy (four patients), cystotomy and evacuation (one patient), and chest wall resection (one patient). There was no mortality. Mean follow-up was 26 months (range, 14 to 36 months). No recurrence has occurred yet.