Bronchogenic cysts are uncommon congenital anomalies of foregut origin and usually located within the mediastinum and the lung. A retrospective study of 33 thoracic bronchogenic cysts was undertaken to detail their clinicopathologic and radiologic features. There were 18 male and 15 female patients between 12 and 77 years of age with a mean age of 41 years. Thirty-one patients (94%) were symptomatic at the time of diagnosis and the chief complaint was chest pain (48.5%). Most of the cysts presented as homogeneous water-density shadows on standard chest radiographs. The location was intrapulmonary in 25 cases and mediastinal in 8 cases. Based on radiologic investigations, preoperative diagnosis of bronchogenic cyst was made in only 11 cases (33.34%). Surgical excision of the cyst was approached via thoracotomy in 32 cases and thoracoscopy in one case. Total excision of the cyst was performed in 31 cases and subtotal resection in 2 cases. Pathologic findings were consistent with bronchogenic cyst in all cases. During the follow-up period, which ranged between 1 month and 51 months, all patients were symptom-free with no evidence of recurrence. Complete surgical resection is recommended for all bronchogenic cysts to establish diagnosis, alleviate symptoms, and prevent complications.
Cutaneous metastases of lung cancer are of poor prognosis. They are most of the time associated with an advanced neoplastic process with metastasis to other organs. Median survival after skin involvement does not exceed months.
Elastofibroma is a rare benign soft tissue lesion, typically located deep under the lower pole of the scapula. It is characterized by a fibrous and adipose tissue proliferation and most frequently affects older females. Its characteristic location and its specific aspect in imaging studies most often provides the diagnosis following an incidental discovery. Nevertheless, anatomic and pathologic confirmation is necessary to formally rule out a malignant tumor diagnosis. We report a 66-year-old woman original observation; this lady's occupation involved a number of strenuous manual activities; she consulted for chronic pain related to a left subscapular mass. MRI demonstrated, in fact, two symmetrical tumor masses under each scapula. The only symptomatic lesion was surgically excised.
Glomus tumors of the trachea are extremely rare and generally benign, with very few cases of malignant transformation reported in literature. We present the case of a 74-year-old man explored for cough and dyspnea. Bronchoscopy showed a polypoid mass arising from the posterolateral tracheal wall. Computed tomography demonstrated a mid-tracheal tissular mass obliterating the tracheal lumen. Resection and anastomosis of the trachea were performed. The histological and immunohistochemical findings were consistent with malignant glomus tumor.
Expression of the KLK13 and KLK14 genes was examined at the mRNA and protein levels in a cohort of 57 patients with non-small-cell lung cancer (NSCLC). The mRNA levels, assessed by real-time RT-PCR, were significantly different in malignant tissues compared to adjacent non-malignant tissues (KLK13, p=0.006; KLK14, p=0.022). KLK13 and KLK14 mRNA overexpression in tumors (1/3 of the patients) was associated with a positive nodal status in multivariate analysis (p=0.018 and p=0.069, respectively). KLK13 and KLK14 were localized in the cytoplasm of epithelial cells of normal bronchus and NSCLC, as determined by immunohistochemistry. Moreover, positive staining was significantly associated with adenocarcinoma histotype (KLK13, p=0.014) and tumor size (KLK14, p=0.048). Although the results are marginally significant, patients with high KLK13 expression at the mRNA or protein level had lower overall survival.
Although it is considered to be a benign lesion, this tumor can be locally very aggressive, and has a high local recurrence rate depending upon the efficacy of surgical resection.
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