Tracheal chondrosarcoma

Tracheal chondrosarcoma are rare diseases, with only 15 cases previously described in the literature between 1959 and 2008. Here we present a rare case of tracheal chondrosarcoma and a review of the literature. Our patient, a 72-year-old man, had progressive throat pain for 2 years before diagnosis. Clinical and imaging investigation revealed a giant tracheal mass that was partially debulked by laser for symptomatic relief. Histologically, the mass was characterized as a low-grade tracheal chondrosarcoma. The patient underwent external-beam radiotherapy (EBRT) and received 60 Gy. At the time this report was written, 7 years after the end of the treatment, the patient was alive and asymptomatic without evidence of locoregional disease. This case and some described in the literature demonstrate the value of EBRT as a single treatment modality in achieving local control. More experience is required to establish the definitive role of radiotherapy in low-grade tracheal chondrosarcoma (AU)

[Whole lung lavage - Report of four cases of alveolar proteinosis]. / Lavagem pulmonar total - A propósito de quatro casos de proteinose alveolar.

Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs. This review describes the whole lung lavage, its major indication, alveolar proteinosis and some data on the experience of our hospital.

Tracheo-esophageal fistula: combined surgical and endoscopic approach.

We present a case of benign acquired tracheo-esophageal fistula caused by cuffed tracheal tube. The patient was septic and weaning from the mechanical ventilation was unlikely, so immediate repair of the tracheal and esophageal lesions was imperative. A silicone endoprosthesis was inserted in the tracheal lumen and the esophageal lesion was repaired with direct suture. After weaning from mechanical ventilation and recovery, the patient was discharged with a silicone tracheal stent. Three months later the stent was removed without complications or need for further treatment. This combined approach as never been published before, and can be a very useful alternative for the treatment of this rare but taxing complication.

[Percutaneous cholangiography: Chiba method, a diagnostic advance]. / Colangiografia transcutânea: método de Chiba, um avanço diagnóstico.

Employing percutaneous transhepatic cholangiography by CHIBA method in 15 patients, it was possible to visualize biliary system in 93.3% of the cases. The radiologic diagnostic of KLATSKIN tumor was observed in 2 cases, 4 cases of carcinoma of the papila of VATER, 1 case of carcinoma of the terminal choledochus, 1 case of intrahepatic neoplasia, 1 case of stenosis secondary to choledocal, trauma, and in another it was damaged by subcapsular hepatic leakage of contrast. The complications were minor. In 5 cases the patients had biliary colic at the time of the exam. In 2 cases, signals of baeteremia occurred in the day following the exam, and in 4 cases there was a small subcapsular hepatic leakage of contrast. In one case it was encountered hematoma under the capsule of the liver, during surgery. The diagnosis was confirmed at surgery in 12 cases. We concluded that the simplicity of the technic, its low cost and its diagnostic, accuracy have made it extremely useful.