Benign tracheal stenosis is situation that occurs usually after stress is applied to a certain area in the trachea during the intubation of a patient or inflammation caused during an infection. In the current case report we will present a 65-year-old man with a benign tracheal stenosis due to a 15-day intubation with a high pressure and low volume intubation tube. Current methodology was applied in his case with an excellent result with a 1-year follow up. Cryotherapy, electrocautery-knife, balloon dilation and semi-rigid bronchoscopic technique were applied.Currently there are several techniques that can be used by pulmonary physicians or ear, nose and throat experts. It remains for the treating physician to choose its method based on his training, equipment and tissue damage.
Lung cancer is still diagnosed at a late stage in most lung cancer patients. Regarding Non-small Cell lung cancer there are novel therapies such as; tyrosine kinase inhibitors and immunotherapy. Currently we have two immunotherapies that can be used either as first-line treatment or second line treatment; pembrolizumab and nivolumab. A third one is being investigated as a combination of immunotherapy; ipilimumab. Aerosol treatment has been investigated for many diseases not only for the lung, but also for systematic diseases. The design of cups was found the most significant factor in producing significant effects. The comparison of cups reveals the design J as the most capable of reducing the droplets at a minimum size of mass median aerodynamic diameter (MMAD) MMAD=1.99. Drug effect comes second in sequence (F=62.04) showing that nivolumab is the most drastic preparation at low particle sizes (1.89), two drugs share an intermediate particle diameter (pembrolizumab and ipilimumab). In total drugs demonstrate a decreasing droplet size: Ipilimumab>Pembrolizumab> Nivolumab.
Small cell lung cancer (SCLC) represents approximately 15% of all lung cancer diagnoses and over the last 20 years, in the Western world, the proportion of patients with SCLC has decreased to 13% due to world campaign for smoking cessation. Due to high growth fraction of the disease, to early dissemination with widespread metastases and also to early development of drug resistance, the treatment of SCLC remains discouraging. The median survival time without treatment is 2-4 months and with treatment the 5-year survival rate remains low at <7% overall and the most of the patients relapse within one year after first-line treatment. Chemotherapy with a platinum regimen and etoposide is the gold of standard of treatment for limited (LD) and extensive disease (ED), by adding radical thoracic radiotherapy for patients with good performance status, with LD. The new TNM classification should be used also for SCLC. For the patients who have any response is indicated the prophylactic cranial irradiation (PCI) due to high risk of brain metastases. The benefit from second-line therapy is limited and maintenance therapy did not appear to improve overall survival (OS) or progression free survival (PFS) for patients with SCLC. Many targeted agents have been investigated in LD and ED, almost all of them in unselected populations, but also with pessimistic results. Due to unchanged therapeutic options for almost four decades, is required desperately to understand better the molecular basis of SCLC and to proceed in to clinical trials for new drugs and targeted agents.
Multiple primary malignant neoplasms (MPMN) is an uncommon phenomenon, while the diagnosis of such conditions is very significant. Considering that the strategy of the treatment is determined by the histological type of the tumor, practitioners should be alert in order to avoid malpractices in cases of multiple metachronous or synchronous malignancies. In this article we report two rare cases of MPMN. The first patient suffered from three metachronous malignant neoplasms, specifically tonsillar, lung and breast cancer, while the second patient was diagnosed with four synchronous and metachronous malignant tumors, including renal and lung cancer, basaloid carcinoma and melanoma. Such cases are extremely rare in the clinical practice and poorly described in the literature.
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