RESUMEN
Unlike lung metastases of extrapulmonary sarcomas, primary sarcoma of the lung is very rare. We analyzed 7 primary sarcomas treated surgically in Hospital Universitario La Paz, Madrid, Spain between 1985 and 2001. Preoperative histologic diagnosis was correct for 2 patients. Surgery was performed in all 7 patients. Resection was extended to the left atrium in 1 patient, to the chest wall in another, and the parietal pleura were removed from 2 others. Surgical resection was considered complete in 6 cases. Histology revealed 4 cases of malignant fibrous histiocytoma, 1 angiosarcoma, 1 osteogenic sarcoma, and 1 undifferentiated sarcoma. Enlarged lymph nodes removed during surgery were tumor free. Three patients received complementary treatment. The 3 longest-surviving patients were treated with surgery alone; at the end of the study, these patients remained alive 16, 9, and 4 years after surgery. One patient has a recurrent lymph node tumor in a single lung. Three patients died within 1 year and another died 24 months after surgery. In conclusion, surgical treatment of primary sarcoma of the lung can achieve good survival.
Asunto(s)
Neoplasias Pulmonares/cirugía , Sarcoma/cirugía , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Periodo PosoperatorioRESUMEN
Los sarcomas primitivos pulmonares son muy raros, pero no los metastásicos. Se analizaron 7 sarcomas primarios operados en nuestro servicio entre 1985 y 2001. El diagnóstico histológico preoperatorio fue correcto en 2 pacientes. Se realizó cirugía en todos. En uno se amplió la resección a aurícula izquierda, en otro a pared torácica y en otros 2 se extirpó pleura parietal. Se consideró cirugía completa en 6 casos. En el estudio histológico 4 fueron fibrohistiocitomas malignos, uno angiosarcoma, uno sarcoma osteogénico y uno sarcoma indiferenciado. Las adenopatías extirpadas estaban libres de tumor. Se hizo tratamiento complementario en 3 pacientes. En los 3 de mayor supervivencia se realizó sólo cirugía, con un seguimiento de 16, 9 y 4 años, respectivamente. Uno tiene actualmente una recidiva tumoral nodular en pulmón único. En cuanto a los fallecidos, 3 murieron antes de un año y otro después de 24 meses de evolución. En conclusión, la cirugía en los sarcomas pulmonares primitivos puede conseguir una elevada supervivencia
Unlike lung metastases of extrapulmonary sarcomas, primary sarcoma of the lung is very rare. We analyzed 7 primary sarcomas treated surgically in Hospital Universitario La Paz, Madrid, Spain between 1985 and 2001. Preoperative histologic diagnosis was correct for 2 patients. Surgery was performed in all 7 patients. Resection was extended to the left atrium in 1 patient, to the chest wall in another, and the parietal pleura were removed from 2 others. Surgical resection was considered complete in 6 cases. Histology revealed 4 cases of malignant fibrous histiocytoma, 1 angiosarcoma, 1 osteogenic sarcoma, and 1 undifferentiated sarcoma. Enlarged lymph nodes removed during surgery were tumor free. Three patients received complementary treatment. The 3 longest-surviving patients were treated with surgery alone; at the end of the study, these patients remained alive 16, 9, and 4 years after surgery. One patient has a recurrent lymph node tumor in a single lung. Three patients died within 1 year and another died 24 months after surgery. In conclusion, surgical treatment of primary sarcoma of the lung can achieve good survival
Asunto(s)
Masculino , Femenino , Adulto , Anciano , Persona de Mediana Edad , Humanos , Sarcoma/cirugía , Neoplasias Pulmonares/cirugía , Estudios de Seguimiento , Periodo PosoperatorioRESUMEN
Seventy-three interventions for chest wall tumors were performed at our hospital from 1978 through 2003. Six (8.2%) tumors were vascular. Four of them were soft tissue tumors, and two involved bone. The histologic diagnoses were hemangioendothelioma (1), low-grade angiosarcoma (1), and hemangioma (4). The diagnosis was established after surgery in all cases except one that had been previously diagnosed during an attempted resection before the patient came to our hospital. Fine needle aspiration carried out in 4 patients was inconclusive in all cases. Complete tumor resection with a margin greater than 3 cm was performed in each patient. Embolization followed by ligation of the intercostal vessels was performed prior to tumor resection in 1 patient with arteriovenous fistula and diffuse angiomatosis. Chest wall reconstruction after tumor removal was carried out using autologous tissues except in 1 case in which a Marlex mesh (CR Bard Inc., Burlington, USA) and a metallic prosthesis was inserted to prevent deformity in the lower costal arch. All patients have been followed and have survived with no evidence of recurrence after follow up ranging from 2 to 25 years.