Malignant fibrous histiocytoma (MFH) cases are classified within the group of nonclassified sarcomas. The etiopathogenesis is unclear; however, MFH commonly develops in scar tissue and in areas exposed to radiation. MFH is the most common soft tissue sarcoma in adults and may be borne in the lungs, chest wall, mediastinum, or other tissues. Primary MFH of the lung constitutes less than 0.2% of all pulmonary neoplasms; thus, an optimal treatment strategy has not yet been elucidated. We aimed to report a case of MFH of the lung with subsequent treatment administration.
Background Spontaneous pneumothorax usually occurs as a result of rupture of a subpleural bleb or emphysematous bulla. Spontaneous pneumothorax, which is more common in younger age groups, might be the first sign of pulmonary malignancy, especially when it manifests in older patients. Methods Data of all patients who were treated for spontaneous pneumothorax in our clinic between June 2013 and June 2017 were examined retrospectively. The demographic characteristics, diagnostic methods, pathologic subtypes, and treatment protocols applied in patients diagnosed with malignancy during the treatment period were investigated. Results Out of 1187 patients, 9 (0.8%) had incidental pulmonary malignancies. Metastatic lung cancer was detected in 2 of 9 patients, while primary lung cancer was detected in the other 7. Six patients were operated on and the other 3 were referred for oncologic treatment for various reasons. Conclusions We suggest that cases of spontaneous pneumothorax in advanced age should be evaluated in a more detailed fashion, and further investigations should be carried out with suspicion of an underlying pulmonary malignancy.
Destroyed lung is a term used when there is disseminated destruction of the lung parenchyma caused by a chronic infectious or inflammatory pulmonary disease. Tuberculosis and bronchiectasis are the most common causes of destroyed lung described in the literature. The main hindrances to use of a videothoracoscopic (VATS) surgical approach in these cases are dense fibrotic adhesions or additional shrinkage of the thoracic cavity as a result of chronic inflammation. A 42-year-old woman presented with the complaint of intervals of hemoptysis, which had been ongoing for 6 months. Thorax computed tomography showed generalized bronchiectasis and parenchymal destruction in the right lung. A right pneumonectomy was performed via the 2-port VATS technique. This case was presented in order to demonstrate that even during a thoracotomy with adhesiolysis and difficult vessel dissection, VATS resection can be performed safely, and to highlight some of the potential intraoperative difficulties.
Chylothorax cases are associated with several etiologies. Non-Hodgkin lymphoma and intrathoracic surgical trauma are the most frequent reasons, but approximately 15% of the cases are idiopathic. Idiopathic chylothorax is thought to be related to minor trauma, and damage above the fifth thoracic vertebra is known to lead to left-sided effusion. In this report, we describe a left-sided chylothorax with an etiology that was finally identified by an in-depth interrogation of the patient's past medical history. Several days previously, while he was weight training with his left arm, he experienced serious pain in his scalenus anterior muscle area. We thought that overstretching of the subclavious and anterior scalenus muscle might have led to the rupture of the left lymphatic duct. Traumatic chylothorax after weight lifting is a rare entity. Awareness and a high degree of suspicion are important in cases of unusual pleural effusion.
Background Flail chest is the most serious complication that may occur after thoracic trauma. In this article, we present a case of flail chest caused by blunt chest trauma, which presented dramatic clinical improvement following rib fixation and chest wall reconstruction. Case Description A 53-year-old male patient with flail chest because of the trauma who had been followed in intensive care unit for mechanical ventilatory support underwent chest wall stabilization with titanium reconstruction plate and screws. Conclusion The main objective is surgical stabilization of the chest wall in cases of flail chest with a parenchymal damage because of the severe rib fracture, which need prolonged mechanical ventilation.
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