Long-term stent implantation in a case of relapsing intrathoracic Ewing-sarcoma.
The overall prognosis of relapsing Ewing sarcoma is poor and therapeutic options can be limited by extensive chemotherapeutic pretreatment. We report on a case of a 27-year-old male, presenting with a large mediastinal mass and malignant pleural effusions. 5 years prior peripheral Ewing sarcoma had been treated according to the CESS 86 protocol. Relapse chemotherapy was initiated (CESS protocol) but tumor progression led to stenoses of both main bronchi. At this critical point, 2 Strecker tantal stents were placed endoscopically to prevent suffocation and provide the time for further chemotherapy, regardless of the poor overall prognosis. Complete remission was achieved by high-dose ifosfamide, surgery, radiotherapy and adjuvant ifosfamide. In spite of possible complications of long-term stent implantation, the stents were not removed until 4 years later when stent dislocation occurred. After removal, the stents were epithelialized and electron microscopy demonstrated structural integrity of the stent. The patient has remained in complete remission since (6 years).
Department of Pneumology, Klinikum Innenstadt der Universität München, Germany. slang@medinn.med.uni-muenchen.de
S M
SM
Lang
D
D
Kotsianos
I
I
Schmitz
H
H
Hautmann
B
B
Emmerich
R M
RM
Huber
D000328:Adult; D001982:Bronchial Diseases / Q000209:etiology / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D008168:Lung / Q000473:pathology / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013510:Pulmonary Surgical Procedures / Q000379:methods*; D012074:Remission Induction; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D015607:Stents