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E. Ucar
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P2.06 - Poster Session/ Screening and Early Detection (ID 219)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.06-017 - Incidental Detection of Lung Cancer by Pre-Operative Evaluation, a Series of 6 Cases (ID 282)
09:30 - 09:30 | Author(s): E. Ucar
- Abstract
Background:
American Society of Anesthesiologists (ASA) classification is an useful pre-operative evaluation system which helps clinicians in prediction of possible complications and risks due to surgery. In ASA classification, surgical candidates are divided into six groups according to their risk status. Following ASA classification, grading is done according to the severity of the operation. Grades are determined due to the severity and the duration of the operation. After determining ASA classes and grades, necessary tests are performed according to age groups to complete the pre-operative assessment. However, in this evaluation, randomly determined pathologies can dramatically change the assessment results in those cases without any symptoms. For this purpose, we retrospectively analyzed the results of the patients received pre-operative pulmonary evaluation during the last one year.
Methods:
Pre-operative pulmonary evaluation results of 520 cases were analyzed retrospectively who were referred to our clinic between January 2014-January 2015.
Results:
Through them, 6 (1.2%) patients (4 men, 2 women) with mass and/or nodule images in their chest radiographs, were histopathologicaly diagnosed with lung cancer. 3 of these cases were planned for inguinal herniorrhaphy, and other 3 cases for knee replacement surgery. The common points of these cases were being asymptomatic and included into ASA 1 - grade II group. The mean age of the patients was 71.1 (65- 87). Lung cancer diagnosis was proven by transthoracic needle biopsy in 3 cases, bronchoscopy in 1 case and thoracentesis + pleural biopsy in 1 case with pleural effusion. All of the cases are non-small cell lung cancer; 3 adenocarcinoma and 3 squamous cell lung carcinoma. 4 cases were found to be in stage IIIB and over, while the other 2 patients who were underwent lobectomy were in stage IB. Chemoradiotherapy was performed to the inoperable cases.
Conclusion:
Pre-operative tests conducted according to current ASA classification are still useful in terms of determining the possible complications and risks. However, in some cases, as in ours, examinations broader than recommended may be necessary. According to ASA classification; ASA group 1describes healthy person with no systemic problem accept for current surgical pathology, and grade 2 describes short timed operations (30 minutes - 1 hour) in which vital organs are affected minimum (inguinal herniorrhaphy, tonsillectomy, arthroscopy, cystoscopy, etc.). ASA recommends preoperatively complete blood count, serum electrolytes, blood glucose, blood urea nitrogen, creatinine tests for ASA group 1- grade II patients aged 61 years and older. Chest radiography is not routinely recommended in these patients with no obvious symptoms or signs. However, in our own clinical approach for pre-operative evaluation of patients aged over 65 years, chest radiograph is a preferred test. Considering that 6 asymptomatic lung cancer patients were determined by this approach, the benefits of pre-operative chest radiograph which is a cheap, fast and easy examination are remarkable in pre-operative pulmonary evaluation. We presented this case series in order to emphasize this subject.
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P3.06 - Poster Session/ Screening and Early Detection (ID 220)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.06-021 - Lung Cancer Presented with Neurological Symptoms and Diagnosed after Brain Surgery (ID 252)
09:30 - 09:30 | Author(s): E. Ucar
- Abstract
Background:
Lung cancer is still one of the the most important and common mortality cause. Although, the presentation and course of the disease differ with the cell type, usually typical symptoms are seen. The most common symptoms include fatigue, weight loss, shortness of breath, and chest pain. These symptoms especially in smoking patients suggest lung cancer first. But in some cases paraneoplastic syndromes and symptoms of other systems caused by diffusing cancer come forward. Such findings are most common in small cell lung cancers (SCLC) among lung cancers. Because early metastasis and paraneoplastic syndromes SCLC can have very different clinical presentations.
Methods:
To emphasize this issue, we present a case of SCLC having only neurological signs.
Results:
60 years old male patient with a history of 70 pack years smoking, admitted to neurology clinic with vertigo, headache, nausea, and changes in consciousness. Because of the tumoral lesion in the left cerebellum seen in brain computed tomography, he was referred to brain surgery. Although, a preoperative thorax tomography revealed a mass lesion in left lung, he was operated for palliation of neurological symptoms and pathological diagnosis. Intraoperative frozen sampling diagnosed as small cell lung cancer. Patient is still followed by our department and radiation oncology.
Conclusion:
We present this case as a reminder of lung malignancies can be met by different presentations.
