Diagnosis and Treatment of Giant Intrathoracic Tumors
https://doi.org/10.58838/2075-1230-2023-101-2-20-29
Abstract
The objective: to determine the indications and possibility of surgical treatment of giant malignant intrathoracic tumors.
Subjects and Methods. The authors presents their own experience of treatment of 19 patients with giant malignant intrathoracic tumors.
Results. Overall resectability was 79% (15/19 patients). 4 patients underwent combined surgery: in 2 patients, the tumor was removed with resection of a part of the upper lobe of the lung; 1 patient had this left lung resected (pneumoectomy); and 1 patient had type A thymoma, so resection and reconstruction of the pulmonary arterial trunk was performed. Radicality was assessed both during surgery (R2 – in 3 patients) and during morphological testing of surgical specimens (R1 – in 1 patient).
Among the operated giant neoplasms of the chest, which did not include lymphomas and extra-gonadal dysgerminogenic tumors, thymoma (7/19; 36.8%) and neoplasms of neurogenic origin (3/19; 31.6%) of varying degrees of differentiation were more often diagnosed.
The examination algorithm of these patients and decision-making on surgical tactics are presented. The article discusses access options and technical surgical methods for removing large tumor masses with a specific clinical examples.
About the Authors
V. D. Parshin
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health; Russian Medical Academy of On-going Professional Education, Russian Ministry of Health
Russian Federation
Russian Federation
Vladimir D. Parshin - Doctor of Medical Sciences, Professor, Correspondent Member of the Russian Academy of Sciences, Laureate of the State Prize of the Russian Federation, Head of Thoracic Surgery Center, Head of Thoracic Surgery Department, Russian Medical Academy of On-going Professional Education
4, Dostoyevsky St., Moscow, 127473
I. M. Koroleva
Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health
Russian Federation
Russian Federation
Irina M. Koroleva - Doctor of Medical Sciences, Professor, Radiologist of the Radiological Diagnostic Department, University Hospital no. 1, Sklifosovsky Clinical Center
8, Bd. 2, Trubetskaya St., Russia Moscow, 119991
A. V. Parshin
Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health
Russian Federation
Russian Federation
Aleksey V. Parshin - Candidate of Medical Sciences, Assistant of Faculty Surgery Department no. 1, Sklifosovsky Clinics
8, Bd. 2, Trubetskaya St., Russia Moscow, 119991
M. A. Mischenko
Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health
Russian Federation
Russian Federation
Maria А. Mischenko - Candidate of Medical Sciences, Radiologist of the Radiological Diagnostic Department, University Hospital no. 1, Sklifosovsky Clinical Center
8, Bd. 2, Trubetskaya St., Russia Moscow, 119991
V. V. Parshin
Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health
Russian Federation
Russian Federation
Valery V. Parshin - Candidate of Medical Sciences, Thoracic Surgeon, Oncologist of Surgical Oncology Department, University Hospital no. 1, Sklifosovsky Clinical Center
8, Bd. 2, Trubetskaya St., Russia Moscow, 119991
A. V. Ponasenko
Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health
Russian Federation
Russian Federation
Aleksandra V. Ponasenko - Anesthesiologist of Anesthesiology Department, University Hospital no. 1, Sklifosovsky Clinical Center
8, Bd. 2, Trubetskaya St., Russia Moscow, 119991
References
1. Ablitsov Yu. A., Ablitsov A. Yu., Vasilashko V. I., Orlov S. S. Surgical treatment of giant tumors of the chest. Vestnik Nacional'nogo mediko-hirurgicheskogo Centra im. N. I. Pirogova, 2008, vol. 3, no. 2, pp. 126–128. (In Russ.)
2. Basankin I. V., Porkhanov V. A., Takhmazyan K. K., and Kononenko V. B., Straub V. V., Sitnik S. D., Zyablova E. I., Pashkova I. A., Fedorchenko A. N., Bukhtoyarov A. Yu. Giant cell tumor of the thoracic spine. Clinical case of effective radical spondylectomy of three vertebrae. Innovacionnaja medicina Kubani, 2017, vol. 3, no. 6, pp. 21–27. (In Russ.)
3. Brierley J. D., Gosdarovic M. K., Wittekind K., eds. TNM klassifikacija zlokachestvennyh opuholej. (Russ. Ed.: TNM classification of malignant tumors). Translited from English by Dubova E. A., Pavlov K. A., Moscow, Logosphere Publ., 2018.
4. Vetshev P. S., Ablitsov Yu. A., Ablitsov A. Yu., Vasilashko V. I., Kryachko V. S., Lukyanov P. A. Multi-stage surgical treatment of recurrent thymoma. Vestnik Nacional'nogo mediko-hirurgicheskogo Centra im. N. I. Pirogova, 2017, vol. 12, no. 4, pp. 142–144. (In Russ.)
5. Gagua R., Kuchava V., Gzirishvili L., Lomidze Z. Diagnosis and results of surgical treatment of rare giant intrathoracic tumors. Hirurgija im. N. I. Pirogova. 2017, no. 6, pp. 21–25. (In Russ.)
6. Ganul A. V., Borisyuk B. A., Semivolos A. V., Kondratsky Yu. N., Shevchenko A. I., Sovenko V. M., Kobzev O. I., Bororov L. V. Giant tumors of intrathoracic localization. Klinicheskaja onkologija. 2017, vol. 6, no. 2, pp. 20–24. (In Russ.)
7. Davydov M. I., Aksel E. M. Statistics of malignant neoplasms in Russia and the CIS countries in 2008. Vestnik RONC im. N. N. Blohina RAMN, 2010, vol. 80, no. 2, 160 p. (Appen. 1). (In Russ.)
8. Davydov M. I., Davydov M. M., Gerasimov S. S., Charchyan E. R., Gruzdev V. E., Machaladze Z. O., Abdulaev A. G., Tagieva H. S. Surgical treatment of a patient with giant neurosarcoma of the posterior mediastinum. Vestnik RONC im. N. N. Blohina RAMN, 2015, vol. 26, no. 1, pp. 73–75. (In Russ.)
9. Davydov M. I., Polotsky B. E., Machaladze Z. O. et al. Treatment of extragonadal germ cell tumors of the mediastinum.Vysokie tehnologii v onkologii. Materialy 5 Vseros. s’ezda onkologov. [High technologies in oncology. Abst. Book of the Vth All-Russian congress of oncologists]. – Kazan, 2000, 43 p. (In Russ.)
10. Davydov M. I., Polotsky B. E., Machaladze Z. O., Tyulyandin S. A., Akhmedov B. B. et al. Extraganadal tumors of the mediastinum. Vestnik RONC im. akad. N. N. Blohina, 2007, vol. 18, no. 4, pp. 43–49. (In Russ.)
11. Kolbanov K. I., Pikin O. V., Ryabov A. B., Glushko V. A. Tumors of the mediastinum: classifications. Onkologija. Zhurnal im. P. A. Gercena, 2019, vol. 8, no. 6, pp. 471–478. (In Russ.)
12. Koroleva I. M., Parshin V. D., Mukhamatullina E. Z., Mishchenko M. A. Possibilities of wide-detector MSCT in assessing invasion of mediastinal structures in giant neoplasms of the chest organs, Consilium Medicum. 2019, vol. 24, no. 9, pp. 595–602. (In Russ.)
13. Machaladze Z. O., Davydov M. I., Polotsky B. E., Karseladze A. I. Savelov N. A. Tumors of the soft tissues of the mediastinum. Grudnaja i serdechno-sosudistaja hirurgija, 2008, no. 1, pp. 59–65. (In Russ.)
14. Parshin V. D., Mirzoyan O. S., Titov V. A., Parshin A. V., Zulufova I. D. Surgical treatment of giant thymoma complicated by chest compression syndrome. Zhurnal im. N. I. Pirogova Khirurgiya, 2019, no. 12, pp. 132–136. (In Russ.)
15. Pikin O. V., Alexandrov O. A. Diagnostic and therapeutic-tactical errors in patients with mediastinal tumors. Onkologija. Zhurnal im. P. A. Gercena, 2020, vol. 9, no. 1, pp. 72–78. (In Russ.)
16. Trakhtenberg A. Kx. Opuholi sredostenija. V kn.: V. I. Chissov (eds.) Kombinirovannoe i kompleksnoe lechenie bol'nyh so zlokachestvennymi opuholjami. [Tumors of the mediastinum. In: Combined and complex treatment of patients with malignant tumors], Moscow, 1989, pp. 278–290.
17. Ahmad U., Yao X., Detterbeck F., Huang J., Antonicelli A., Filosso P. L, et al. Thymic carcinoma outcomes and prognosis: results of an international analysis. J Thorac Cardiovasc. Surg., 2015, vol. 149, no. 1, pp. 595–602. https://doi.org/101016/jjtcvs201409124
18. Cardillo G., Carleo F., Khalil M. W., Carbone L., Treggiari S., Salvadori L., et al. Surgical treatment of benign neurogenic tumours of the mediastinum: single institution report. Eur. J. Cardiothorac. Surg., 2008, vol. 34, no. 6, pp. 1210–1214. https://doi.org/10.1016/j.ejcts.2008.09.006
19. Donohue J. P., Foster R. S. Management of retroperitoneal recurrences: Seminoma and Nonseminoma. Urol. Clin. N. Am., 1996, vol. 21, no. 4, pp. 761–772.
20. Fujimoto K., Hara M., Tomiyama N., Kusumoto M., Sakai F., Fujii Y. Proposal for a new mediastinal compartment classifcation of transverse plane images according to the Japanese Association for Research on the Thymus (JART) General Rules for the Study of Mediastinal Tumors. Oncol. Rep., 2008, vol. 31, no. 2, pp. 565–572. https://doi.org/10.3892/or.2013.2904
21. Huang J., Ahmad U., Antonicelli A., Catlin A. C., Fang W., Gomez D., et al. Development of the international thymic malignancy interest group international database: an unprecedented resource for the study of a rare group of tumors. J. Thorac. Oncol., 2014, vol. 9, no. 10, pp. 1573–1578. https://doi.org/10.1097/JTO.0000000000000269
22. Scardino P. T., Cox H. D., Waldmann T. A. et al. The value of serum tumor markers in the staging and prognosis of germ cell tumors of the testis. J. Urol., 1977, vol. 118, no. 6, pp. 994–999.
Review
For citations:
Parshin V.D., Koroleva I.M., Parshin A.V., Mischenko M.A., Parshin V.V., Ponasenko A.V. Diagnosis and Treatment of Giant Intrathoracic Tumors. Tuberculosis and Lung Diseases. 2023;101(2):20-29. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-2-20-29
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