Denise Ouellette

Lung cancer in women compared with men: stage, treatment, and survival

BACKGROUND In cardiac disease there appears to be a difference in the treatment of men and women, and thus an advantage in survival in men. This study aimed to determine whether these differences exist in lung cancer. METHODS We undertook a retrospective cohort study in a university hospital. The study population consisted of 104 consecutive women and 104 consecutive men with newly diagnosed lung cancer between March 1988 and June 1990. The following information was collected: sex, age, presenting symptoms, investigations, histology, stage, treatment, and survival. RESULTS The location of the tumor, presenting symptoms, investigations, and stages were similar in men and women. There was a difference in the distribution of the various histologic types of lung cancer: Small cell lung cancer was more frequent in women (25% versus 11.5% in men) and squamous cell carcinoma more frequent in men (38% in women versus 51% in men). The overall survival was similar among the two sexes, but there was a survival advantage in women when adjusted for stage. CONCLUSIONS There was a higher incidence of small cell carcinoma in women and squamous cell carcinoma in men. There was evidence of a difference in the survival rate of lung cancer in favor of women according to stage.

Unsuspected metastatic choriocarcinoma presenting as unilateral spontaneous pneumothorax

Spontaneous pneumothoraces are usually caused by subpleural apical blebs but may also be secondary to metastasis to the lung. We present the case of a 20-year-old woman with spontaneous pneumothorax secondary to choriocarcinoma metastatic to the lung.

Solitary fibrous tumour of the pleura: A case report

Solitary fibrous tumours of the pleura are rare pleural neoplasms that are distinct from mesothelioma. Most of them are benign, although some behave aggressively; morphological and pathological features are important in distinguishing them from mesothelioma and in predicting clinical behaviour. Solitary fibrous tumours often grow to a large size before causing symptoms, and are characteristically associated with hypertrophic pulmonary osteoarthropathy in up to 20% of cases. In cases of benign lesions, complete resection is usually curative. A case involving a 62-year-old woman who underwent surgical resection of a solitary fibrous tumour of the pleura measuring 25 cm in size is described.

A Curious Lobe

A case of azygos lobe is presented. An azygos lobe is an accessory lobe of the lung that may occasionally be confused with a pathological process such as a bulla, lung abscess or neoplasm. Its pathogenesis is discussed, as are the characteristic x-ray features that enable an accurate diagnosis.

Obstructive bronchial hamartoma

A 47-year-old woman presented with a persistent cough of two months’ duration. She was a former smoker of 10 pack-years, who had recently been treated with antibiotics for an episode of pneumonia. Her physical examination (including auscultation of lungs) was normal, as was a chest radiograph. In

A patient with an aberrant pulmonary blood supply and recurrent infection.

A case of intralobar pulmonary sequestration presenting with recurrent episodes of infection is reported. Pulmonary sequestration is a rare congenital malformation characterized by accessory lung tissue with no direct connection to the tracheobronchial tree and is supplied by an aberrant systemic artery. The aberrant artery is key to both diagnosis and treatment. The correct diagnosis may be suspected on clinical grounds and should be confirmed by identifying the lesion and aberrant artery on imaging studies. Surgical resection is curative, taking particular care not to injure the aberrant artery, which may result in devastating intraoperative hemorrhage.