RESUMO
Hypoglycemia has multiple causes, but the most common is a complication of insulin treatment. In addition to insulin therapy, tumors such as insulinomas of pancreatic origin and extrapancreatic tumors causing paraneoplastic syndromes should also be considered. Solitary fibrous tumors of the pleura (SFTP) is rare tumor, which when associated with hypoglycemia causes Doege-Potter syndrome. This article reports a case of a 69-year-old man with Doege-Potter syndrome and underwent the first surgical resection for SFTP. However, the tumor recurred 9 years later with hypoglycemic symptoms and implant metastasis. This recurrent tumor originated from the visceral pleura, was more aggressive and invaded the diaphragm and parietal pleura. After the second surgical removal of the tumor, the hypoglycemic symptoms disappeared.
RESUMO
Lung adenocarcinoma, the most common subtype of lung cancer, has been always imposed serious threat to human health. Congenital pulmonary dysplasia (CPD) lacking typical clinical manifestations is a rare developmental anomaly. Pulmonary aplasia, the rarest subtype of CPD, may present with a variety of symptoms and is frequently associated with other abnormalities. This report describes an 81-year-old woman who presented with an irritant cough. Chest computed tomography (CT) and three-dimensional (3D) reconstruction revealed an irregular mass with a diameter of 5 cm in right lower lobe adjacent to the hilum. CT also indicated a rightward mediastinal shift and the complete absence of ipsilateral upper lobar tissue with bronchus ending in a terminal cecum, resulting in a diagnosis of pulmonary aplasia. The patient accepted lobectomy and lymph node dissection without complication, histopathologic examination combined HE staining with immunohistochemistry identified the tumor as adenocarcinoma. Three months after surgery, the patient was free of respiratory symptoms without chest pain. This report highlights the necessity of comprehensive evaluation for lung malignancy concurrent with CPD and the importance of identifying the diagnosis of pulmonary dysplasia.
RESUMO
BACKGROUND: The effect of 4L lymph node dissection on the prognosis of left lung cancer is currently controversial. Therefore, a meta-analysis was conducted to compare the difference in prognosis between the dissection group and the non-dissection group, and assess the independent risk factors for 4L lymphatic metastasis. METHODS: A systematic literature retrieval from PubMed, Embase and CNKI was conducted to identify relevant studies up to October, 5, 2020. The data concerning the overall survival (OS) rate, disease-free survival (DFS) rate, and risk factors for 4L lymphatic metastasis were extracted and analyzed. RESULTS: L10 lymphatic metastasis was an independent risk factor for positive L4 lymph node result (Z=4.89, P<0.05). The probability of positive L4 with positive L10 was 5.11 times of that with negative L10. L5 lymphatic metastasis was an independent risk factor for positive L4 lymph node result (Z=3.92, P<0.05). The probability of positive L4 with positive L5 was 3.92 times of that with negative L5. L7 lymphatic metastasis was not an independent risk factor for positive L4 lymph node result. Positive L4 lymph node decreased the survival rate of relevant patients while L4 lymph node dissection increased the survival rate of relevant patients (Z=2.81, P<0.05 or Z=4.18, P<0.05). Positive L4 lymph node reduced the DFS time of relevant patients while L4 lymph node dissection prolonged the DFS time of relevant patients (P<0.05, Z=2.72). CONCLUSIONS: If the intraoperative pathological examination indicates positive station 10L lymph node, station 4L lymph node will be dissected, which may be a good choice at present. Positive L4 lymph node may reduce the survival time and DFS time of relevant patients while dissection of positive station 4L lymph node may prolong the survival time and DFS time of relevant patients. The intraoperative rapid frozen section pathological examination of station 10L lymph node may be a good choice.
