Preoperative embolization in surgical management of giant thoracic sarcomas.

We report our experience with three cases of giant, highly vascular thoracic sarcomas treated by preoperative embolization and followed, after 48 h by successful excision. With this technique, reduction in tumor size was obtained, ranging from 20% to 32%; perilesional edema facilitated surgical dissection of the mass from the adjacent structures in all cases. Piecemeal removal of the tumor was carried out in two patients with minimal blood loss. In one patient an oligosymptomatic microembolization of the left upper limb was observed with symptoms spontaneously subsiding within 48 h. Preoperative embolization of giant thoracic sarcomas is useful to decrease perioperative blood loss and to facilitate surgery. In huge, highly vascular tumors, preoperative embolization may be essential in order to achieve total excision, especially if piecemeal removal is required.

Lung cancer and skeletal muscle metastases.

Skeletal muscle metastases from lung cancer are rare, and the optimal treatment strategy is unknown. Three cases of skeletal muscle metastases from lung cancer are described. In 2 patients surgical biopsy of muscle swelling disclosed the presence of the lung tumor; the first patient underwent lung resection to remove the primary lesion, the second was not operable because of the metastatic extension of the disease. In the third patient muscle metastasis was observed and excised after lung resection. Adenocarcinoma, squamous cell, and small cell carcinoma were the histologic types diagnosed. Various regimens of radiotherapy and chemotherapy were adopted. Survival times were 3, 6, and 30 months.