Pulmonary carcinosarcoma successfully resected using the rib-cross thoracotomy approach: report of a case.
Pulmonary carcinosarcoma is extremely rare and disease prognosis is very poor. A solid large tumor occupying the left thorax was detected in a 66-year-old female. Rib-cross thoracotomy was performed to excise the tumor; the 5th and 6th ribs and intercostal muscles and vessels were cut along the mid-axillary line, and the thorax was entered posteriorly at the 4th intercostal space and anteriorly at the 6th intercostal space, providing wide exposure of the entire thorax. Left pneumonectomy combined with chest wall resection was successfully performed, followed by chest reconstruction to achieve complete resection. Histopathologically, adenocarcinoma and spindle cell sarcoma containing rhabdomyosarcoma components were identified; the patient was diagnosed with pT3N1M0 stage IIIA true pulmonary carcinosarcoma. Postoperative adjuvant chemotherapy containing cisplatin and vinorelbine was administered. There was no recurrence of the disease 20 months after surgery. Aggressive excision may result in favorable outcomes for pulmonary carcinosarcoma.
Department of Thoracic Surgery, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kake-machi, Okazaki, Aichi, 444-0011, Japan, nskkr@med.nagoya-u.ac.jp.
Noriaki
N
Sakakura
Tatsuo
T
Uchida
Yuka
Y
Kitamura
Motokazu
M
Suyama
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002296:Carcinosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007366:Intercostal Muscles / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011182:Postoperative Care; D019651:Plastic Surgery Procedures; D012272:Ribs / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome; D014747:Vinblastine / Q000031:analogs & derivatives; D000077235:Vinorelbine
D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine