Francesco Quarantotto

Primary Pulmonary Epithelioid Hemangioendothelioma: A Rare Cause of PET-Negative Pulmonary Nodules

We report here a case of primary pulmonary epithelioid hemangioendothelioma diagnosed in a 67-year-old Caucasian man, presenting with exertion dyspnoea, dry cough, and multiple bilateral pulmonary nodules revealed by computed tomography. At the 18F-fluorodeoxyglucose positron emission tomography, these nodules were negative. The histopathological diagnosis was made on a pulmonary wedge resection (performed during video-thoracoscopic surgery).

Long-Term Outcome for Early Stage Thymoma: Comparison between Thoracoscopic and Open Approaches

BACKGROUND Complete surgical excision is the most important long-term prognostic factor of thymomas. Although video-assisted thoracoscopic surgery (VATS) has been reported as an effective treatment to excise mediastinal thymic lesions, it has not replaced median sternotomy as the standard approach because of the lack of long-term follow-up studies. The objective of this study was to analyze and to compare the outcome of VATS extended thymectomy with the traditional open approach. METHODS This is a single centers retrospective study of 27 patients submitted to surgery for early stage thymomas between 1995 and 2007. Histologic subtype and clinicopathologic staging were classified, respectively, according to World Health Organization and Masaoka criteria. Patients with preoperative computed tomography scan evidence of clinical Masaoka stage 1 thymomas were selected for VATS thymectomy with unilateral technique. RESULTS All patients successfully underwent surgery: 3 with VATS and 4 with an open approach. There were no differences in time of surgery and postoperative complication between the two groups. Patients who had VATS had shorter postoperative hospital stay than patients who had open technique. After a median follow-up of 123 months, there were no postoperative recurrences. CONCLUSION VATS is a safe operation and has comparable effectiveness to the open technique in terms of oncological radicality for small, early stage thymoma.

Diffuse pulmonary meningothelial like nodules simulating metastatic thymoma

Diffuse pulmonary meningotheliomatosis (DPM) is a parenchymal lung disease characterized by disseminated bilateral minute pulmonary meningothelial-like nodules (MPMNs). These meningothelial-like nodules are classically encountered as benign solitary or multiple pulmonary nodules containing small epithelioid cell collections nestled within normal pulmonary parenchyma.

A rare case of intralobar pulmonary sequestration: combined endovascular and video-assisted thoracoscopic approach

Pulmonary sequestration is a congenital malformation characterized by cystic, non-functioning embryonic lung tissue supplied by an abnormal systemic artery. Its a rare disease widely variable in clinical presentation and severity, depending mostly on the degree of lung involvement and location in the thoracic cavity. Most patients have recurrent infections and inflammatory conditions in the affected lobe. Surgical resection continues to be the gold standard of therapy and in this context anatomical resection is the procedure of choice and yields excellent long-term results. There are few studies reporting the use of combined endovascular and thoracoscopic approaches for pulmonary sequestration. We describe a case of intralobar pulmonary sequestration located in the lower lobe of the right lung, which was treated with video-assisted thoracoscopic surgery (VATS) after endovascular embolization of systemic artery arising from celiac trunk.

A Rare Case of Solitary Rib MetastasisThirty-Two Years after Resection ofParotid Gland Adenocarcinoma

Context: Parotid adenocarcinoma is a rare salivary gland neoplasm, showing distant metastases in 12%-26% of cases, according to histologic grade. The most frequent locations are the cervical lymph nodes, liver, lungs and bones and metastatic disease is usually associated with poor prognosis. Single late-onset rib metastasis from adenocarcinoma of parotid gland has never been reported in the literature. Case report: We describe the case of a sixty-three-years-old male presenting with an osteolytic rib lesion 32 yrs after surgery for parotid gland adenocarcinoma. The patient was successfully treated with en bloc resection of the 11th rib for parotid gland adenocarcinoma metastasis. The patient has no evidence of local recurrence or metastatic disease 40 months after resection. Conclusion: This case may be useful for making clinical decisions because underlines the challenges of giving patients the optimal treatment considering the limited ability to predict prognosis and highlights the need for careful follow-up even in absence of recurrence for 10 yrs after curative resection.

Gastrointestinal bleeding in lung leiomyosarcoma history: report of a case

The paper presents an unusual case of single small bowel metastasis from primary lung leiomyosarcoma (PLL) presenting with abdominal pain and gastrointestinal (GI) bleeding successfully treated by surgery with radical aim.

Endovascular and thoracoscopic treatment for post-lobectomy hemothorax

Please cite this article in press as: Grossi W, et al. Endovascular and Cardiothorac Surg (2011), doi:10.1016/j.ejcts.2011.05.062 * Corresponding author. Address: Istituto di Chirurgia Generale e Toracica, C.so Giovecca No. 203, Via Arianuova No. 51, Ferrara, 44100 Italy. Tel.: +39 0532 236256; fax: +39 0532 209819. E-mail address: pioman@libero.it (P. Maniscalco). Fig. 1. Chest CT performed for weakness, dyspnea and hemoglobin loss, shows the hemothorax due to the intercostal artery leakage. At discharge the thorax X-ray and the lab test did not show any acute bleeding sign.

Chirurgia Videoassistita del Diaframma

La chirurgia videoassistita del diaframma rappresenta una naturale evoluzione della videotoracoscopia, volta a superare le difficolta tecniche di quest’ultima; questa metodica si pone come compromesso tra la videotoracoscopia e la toracotomia tradizionale: in questo modo il chirurgo ha la possibilita di compiere manovre chirurgiche altrimenti di difficile esecuzione col solo accesso toracoscopico, godendo di un’ottima visione del campo operatorio e dei recessi diaframmatici (visione diretta tramite la minitoracotomia, indiretta tramite il toracoscopio) e, allo stesso tempo sfugge agli inconvenienti derivanti da un’incisione toracotomica standard. L’applicazione della tecnica videoassistita per il trattamento delle patologie chirurgiche del diaframma e del tutto recente: solo nell’ultimo decennio, questa metodica ha trovato indicazione soprattutto in campo pediatrico e traumatologico, essendo divenuta un’eccellente metodica per il trattamento chirurgico della relaxatio ed eventratio diaframmatica e delle ernie post traumatiche, con lacerazione del muscolo.