Author of

• 18670

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  P3.04 - Poster Session with Presenters Present (ID 474)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18713

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    P3.04-043 - Minimally Invasive Small Incision, Muscle- and Rib-Sparing Thoracotomy (miMRST) for Multiple Sclerosing Pneumocytomas (ID 5268)

    14:30 - 14:30  |  Author(s): X. Qiu
    • Abstract

    Background:
    Sclerosing pneumocytoma is less common, multiple sclerosing pneumocytomas are rare. Sclerosing pneumocytoma was called sclerosing hemangioma of the lung before WHO new classification of lung tumors was published in 2015. Here we report two cases, one was multiple sclerosing pneumocytomas, both received surgical resection via minimally invasive small incision, muscle- and rib-sparing thoracotomy (miMRST).
    
    Methods:
    Case 1: a female aged 60 in Aug 2012, chest CT was taken because of cough and fever 38.5℃, a 5cm tumor at right lower lobe, and a 0.8cm nodule at right middle lobe were found. The patient feared of the 30~40cm long “large-incision” of traditional standard posterolateral thoracotomy (TSPT), miMRST was scheduled. Case 2: a male aged 50 in Nov 2012, chest CT revealing an asymptomatic 2cm tumor at right upper lobe. The patient refused TSPT, preferred to accept miMRST.
    
    Results:
    About 10cm lateral chest incision was enough for lung lobectomy and mediastinal lymph node dissection, with the latissimus dorsi and serratus anterior muscles were protected, no rib cut needed. Case 1: right lower lobe lobectomy was performed first, frozen pathological diagnosis: inflammatory lesion with pneumocyte dysplasia, locally with hemangioma-like lesion. Wedge resection was performed to remove the nodule at right middle lobe. Postoperative pathology: both tumors were sclerosing hemangioma of the lung (Aug 2012). Case 2: enucleation was performed, frozen pathological diagnosis: sclerosing hemangioma of the lung, malignancy should be excluded by later paraffin slides staining. Right upper lobe lobectomy with mediastinal lymph node dissection was performed. Postoperative pathology: sclerosing hemangioma of the lung, no lymph node metastasis (Nov 2012). Both patients recovered much better and more quickly than other patients who underwent TSPT in the same ward at that time. Regular follow-up: both are alive healthily in their 4th year postoperatively, no recurrence and metastasis. No adjuvant treatment was used.
    
    Conclusion:
    Multiple sclerosing pneumocytomas are rare. For sclerosing pneumocytoma, surgical resection is of first choice. Limited resection should be enough and reasonable for this kind of benign tumor, however, lobectomy becomes essential once the tumor size is too big, further, mediastinal lymph node dissection is to be performed when malignancy is suspected. miMRST, is minimally invasive thoracic surgery, with no need to use expensive thoracoscopic devices, is very suitable for lung surgery in developing countries. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05).