Tatsuhiro Hoshino

Pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection.

We report a case of a 64-year-old man in whom a partial anomalous pulmonary venous connection (PAPVC) was found before right lower lobectomy for lung cancer. In addition to lung cancer, there was a right superior pulmonary vein that drained into the superior vena cava (SVC). There was a concern of right ventricular heart failure resulting from increased left-to-right shunt flow after lobectomy. Therefore cardiac catheterization was performed to calculate the pulmonary-to-systemic flow rate in the presence of blocked blood flow to the lower lobe pulmonary artery. As a result, we successfully performed lobectomy without correcting the PAPVC.

Angiomyolipoma in the Lung Detected 15 Years After a Nephrectomy for Renal Angiomyolipoma

Angiomyolipoma is generally found in the kidney, but is especially rare in the lung. Nine cases of angiomyolipoma in the lung have been reported previously, and in 3 of these patients it was involved with nephrectomy for renal angiomyolipoma. The origination of the tumor was not completely recognized, but lymphangioleiomyomatosis and angiomyolipoma are known to have a common feature. The pathogenesis of angiomyolipoma in the lung has recently been researched in relation with lymphangioleiomyomatosis. We review these case reports of angiomyolipoma in the lung and discuss the clinical features and the generation of these tumors.

Sclerosing Rhabdomyosarcoma of a Chest Wall in an Adult: A Case Report and Review of the Literature

Sclerosing rhabdomyosarcoma (SRMS) is a newly recognized and rare variant of rhabdomyosarcoma. This soft tissue tumor has not yet been reported as a thoracic lesion. We report a case of a 26-year-old woman who presented with a large chest wall tumor. The tumor originated from the right anterior chest wall and protruded into the intra- and extrapleural cavity. A transcutaneous needle biopsy revealed spindle cells in an abundant hyalinized and fibrous stroma. Although the tumor was considered as a malignant soft-tissue neoplasm, a definitive diagnosis could not be established. A wide excision of the chest wall including the second, third and fourth rib and a part of sternum was performed. Histologically, cytoplasmic cross-striations were found in a portion of the tumor cells. The tumor cells were positive for muscle markers, and the tumor was diagnosed as rhabdomyosarcoma consistent with a sclerosing type of rhabdomyosarcoma. Eighteen months after the complete resection, the patient has pleural disseminations but is alive and undergoing chemotherapy. This case highlights the histologic features of a rare form of rhabdomyosarcoma, and emphasizes the importance of awareness of its existence and the utility of skeletal muscle markers in distinguishing sclerosing rhabdomyosarcoma from its mimics.

Transcatheter aortic valve implantation for patients with lung cancer and aortic valve stenosis

Many patients who require lung resection have cardiovascular and cerebrovascular comorbidities. It has been recommended that surgical aortic valve replacement (SAVR) should precede lung resection in patients with severe aortic valve stenosis (AS). However, by first undergoing transcatheter aortic valve implantation (TAVI), the patient may undergo lung resection more safely. We present two patients with both severe AS and lung cancer who underwent TAVI and lung resection without any complications.