Most retrosternal goiters are situated in the anterior mediastinal compartment, but according to the literature, 10-15% are located in the posterior mediastinum. Although most of the anterior mediastinal goiters can be removed by a transcervical approach, posterior mediastinal goiters may require additional extracervical incisions. We report the case of a huge posterior mediastinal goiter extending from the neck retrotracheally beyond the aortic arch and azygous vein with crossover from the left to the right side and ending at the level of the lower part of the left cardiac atrium, nearly reaching the diaphragm. Surgical removal is the treatment of choice in such cases. We performed an operation using a transcervical and right thoracotomy approach. Histopathological examination confirmed the diagnosis of the large goiter. The patient recovered well and was discharged in 1 week.
A case of patent who was admitted to the unit because of lung tumor is presented in his report. After receiving the cytological diagnosis of the carcinoma non-microcellulare from biopsy taken during bronchoscopy patient was qualified for operative procedure. Upper left lobectomy was performed. During the histological investigation of postoperative specimen the diagnosis of adenocarcinoma GI was established. Furthermore in subsegmental bronchus small tumor which didn't infiltrate the whole bronchial wall was noticed. The diagnosis of carcinoma planoepitheliale keratodes GII was established. For each cancer I stage of disease was established (pT1N0M0). Postoperative period was uncomplicated. In control X-ray after 3, 6, 9 months cancer recurrence wasn't diagnosed. General condition of patient was very good (WHO 0). Patient return to the complete physical activity. Key words: lung cancer, synchronous tumors, operative procedure Neoplasm tumors diagnosed at the same time are called synchronous tumors. If the second tumor appears later, tumors are called metachronous. Synchronous multiple primary lung cancers occur in 1.6-3% of all lung cancers. Synchronous tumors occur much less frequently than metachronous ones, where Synchronous tumors constitute 11-30% of multiple tumors (1, 2). We describe the case of a patient with two synchronous malignant tumors, which were located in the upper left lobe. CASE REPORTA 66 year-old patient (case record number 1340/2007) was admitted to the hospital because of non-specific lesions in chest X-rays. On the day of admission, the patient did not complain of any respiratory ailment. In the chest X-ray, a non-uniform opaqueness in the subclavicular field was diagnosed. In the CT scans, an irregular and fascicular parenchymal density with micronodular lesions and a small area of decreased aerial lung suggesting specific lesions in the apex of the left lung were both described. There were no anatomical changes in the bronchofiberoscopy investigation. A brush biopsy taken from the subsegmental bronchi of upper left lobe during the bronchoscopy established the diagnosis of non-small cell lung cancer. Decreases of the values for haemoglobin and erythrocytes to 13.4 g/dl and 4.37 M/µl, respectively, were found. There were no deviations in spirometry and exercise tests. The patient was qualified to the surgical operative procedure of a left thoracotomy, which was performed under general anaesthesia. The pleural cavity was opened using an antero-lateral incision through the Vth intercostal spaUnauthenticated Download Date | 5/11/18 12:56 AM
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