We believe that wedge resection is a valid surgical intervention for SN type NTM; additional postoperative chemotherapy is unnecessary in cases with no residual lesions in the operated lung lobe.

Cavernous hemangioma is not a neoplasm, but rather a congenital venous malformation with the potential to develop in all parts of the body, though it is very rarely seen in the thymus. We report a case of cavernous hemangioma in the thymus partially resected. A 71-year-old woman presented with pericardial discomfort, and chest computed tomography (CT) showed a left lateral mediastinal mass which was 2.0 × 1.2 × 1.8 cm in size, with border regularity and without calcification. Its interior was partially enhanced. Three-dimensional chest computed tomography image showed a tortuous vessel connecting to the tumor. Surgical resection was performed for the purpose of providing a definitive diagnosis and treatment because a mediastinal tumor such as thymoma or teratoma was suspected. Partial resection of the thymus including the mass was done by utilizing a three-port, left-sided video-assisted thoracic surgery (VATS) approach with hoisting of the third rib with the patient in a spinal position. A wine-colored mass bulging from the surface of the left lobe of the thymus was identified along with the communicating vessel which could only be cut with an energy device. It is considered that thymic partial resection using VATS is a better option for small and non-infiltrative lesions.

A pulmonary lymphoepithelioma-like carcinoma (PLELC) is similar to a lymphoepithelioma, a subtype of nasopharyngeal carcinoma and commonly associated with Epstein-Barr virus infection which is a rare tumour and classified in the group of "other and unclassified carcinoma" in the latest 2015 World Health Organization (WHO) classification. Some reports of lymphoepithelioma-like carcinoma (LELC) have noted an epidermal growth factor receptor (EGFR) mutation, whereas none have noted a mutation of the echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene. This is the first reported case of PLELC with ALK rearrangement. A 76-year-old woman underwent a right lower lobectomy and complicated partial resection of the upper lobe with lymph node dissection under complete thoracoscopic approach. A histopathological diagnosis of PLELC was made and the stage was classified as T1aN1 (#12l) M0, pl0, G2, Ly1, V1. The results of both ALK immunohistochemistry and EML4-ALK fusion gene on fluorescence in situ hybridization (FISH) examinations were positive; however, EGFR mutational analysis results showed wild-type mutation.

LETTERS 85 setting of 1750-3000 mW for 2 s per shot was performed 2 months after the second PPV. At the 1-year follow up, the patient was free of glaucoma medications with IOP at a low level (range 8-12 mm Hg), and the retina was flat, with BCVA at hand movement. The visual outcome was a result of advanced glaucomatous optic neuropathy (vertical cup/disc ratio of 0.9 with pale neuroretinal rim) and severe diabetic exudative maculopathy. The patient did not return for further follow up. CommentTo our best knowledge, this is the first report of delayed and repeated massive suprachoroidal hemorrhage occurring 3 and 5 days after PPV. Reported ocular risk factors for developing intraoperative suprachoroidal hemorrhage include elevated preoperative IOP, history of glaucoma, axial length greater than 25 mm, pseudophakia, scleral buckling, cryotherapy, external drainage of subretinal fluid, rhegmatogenous retinal detachment, and intraoperative Valsalva maneuvers. 3,4 Reported systemic risk factors include hypertension, atherosclerosis, diabetes, advanced age, and intraoperative tachycardia. 4 Our patient, apart from diabetes and hypertension, had none of these risk factors. There was no hypotony before the suprachoroidal hemorrhage. As the prone position was kept for only 3 days, it cannot explain the hemorrhage on the fifth day. Ciliochoroidal effusion has been reported after PRP. 5 We speculate that PRP might have triggered the suprachoroidal hemorrhage. Further studies are needed to elucidate whether delayed suprachoroidal hemorrhage can be precipitated by factors unrelated to intraoperative suprachoroidal hemorrhage.

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BackgroundSurgical resection is the first choice for intralobar sequestration (ILS). A lobectomy is often performed, though we consider that a segmentectomy may be sufficient for benign cases if the sequestration is completely included within a segment.Case presentationWe treated a 36-year-old female diagnosed with ILS. Chest computed tomography (CT) revealed several cystic lesions with niveau formation and consolidation in left segment (S)10 without communication of the bronchus and abnormal artery branching from the descending aorta. We performed a sublobar resection of left S10 including sequestration through a thoracoscopic minimally sized incision. The sequestration had dark red appearance and was completely included in the S10. The boundary line of S10 was clear with inflation of the lung after cutting bronchus 10. The postoperative course was uneventful. Chest CT findings at 2 years after surgery showed good expansion of the residual left lower lobe with no consolidation and respiratory function were nearly the same as the preoperative condition.ConclusionsA thoracoscopic segmentectomy for ILS is a feasible and useful procedure for qualified cases, even in adult patients who had repeated inflammation.