[A rare tracheal malignant tumor: mucoepidermoid carcinoma (a case report)]. / Nadir bir trakea malign tümörü: mukoepidermoid karsinom (olgu sunumu).

An 18-year-old male preferred to our clinic with hemoptysis, cough, dyspnea and stridor. A wide-based polypoid tumor that was localized at the right wall of the distal trachea was observed over 3 cm from the carina by flexible bronchoscope. Computerized tomography showed an intraluminal soft tissue density mass in the trachea. Though right thoracotomy, a tracheal resection that contains three rings of the trachea with malignant lesion was performed. Pathologic examination reported a tracheal mucoepidermoid carcinoma. The patient is alive without recurrence three years after surgery.

Bronchogenic cyst.

The clinical presentation of the bronchogenic cyst is variable, from respiratory distress at birth to late appearance of symptoms. In order to determine clinical features and treatments, we retrospectively studied the medical records and pathology reports of all patients with bronchogenic cysts (n = 22) referred to our surgical department from February 1985 through January 2002. They included 18 male and 4 female patients with an age range of 1 to 38 years (average, 16.4 years). There were 14 mediastinal, 2 hilar, and 6 intrapulmonary bronchogenic cysts. Symptoms were present in 18 of the 22 patients. Cough was the most common symptom (45%). Ten patients (45%) presented with complications: severe hemoptysis, pneumothorax and pleuritis, esophageal compression, infected cyst, and postobstructive pneumonia. In all patients, complete resection of the bronchogenic cyst was performed by thoracotomy A postoperative sequela occurred in only 1 patient, who had a persistent air leak. There were no late sequelae, nor was there a recurrence of the cyst. The follow-up period ranged from 8 months to 12 years (mean, 5.2 years). Because a confident preoperative diagnosis is not always possible and because complications are common, we recommend surgical resection of all suspected bronchogenic cysts in operable candidates.

The efficacy of self-expanding metal stents for palliation of malignant esophageal strictures and fistulas.

OBJECTIVES: Esophageal strictures and esophagorespiratory fistulas are complications of malignant esophageal tumors, which are difficult to manage. The efficacy of self-expanding metal stents (SEMS) for palliation of malignant esophageal strictures and fistulas was investigated prospectively. METHODS: Forty-three SEMS were inserted in 41 patients with malignant esophageal stricture or fistula. Our series included 32 men and nine women, of whom median age was 61.4 years. Twenty nine stents were inserted for stricture, ten for esophago-tracheal fistula, and four esophago-pleural fistula. Stents were inserted endoscopically under fluoroscopic control. RESULTS: SEMS implantation was technically successful in 40 of 41 patients. A second stenting was needed in two patients. Median dysphagia score improved from 3.4 to 1.3. The covered SEMS was succesful in completely sealing 85.7% of the fistulas. Complication occurred in 11 (26.8%) patients. Especially in the case of tumor stenoses in the distal esophagus, complication rate was higher (44%). In total six patients (14.6%) died after stent placement during early postoperative period. Procedure-related mortality was 4.8% (2/41). CONCLUSIONS: We conclude that treatment of malignant esophageal obstructions, including esophagorespiratory fistulas, with SEMS is an alternative palliative procedure. Furthermore SEMS implantation seems more safe in the case of tumor stenoses locating in the middle esophagus.