Eur J Cardiothorac Surg 2004;25:1122-1123
© 2004 Elsevier Science NL
Images in cardio-thoracic surgery |
Lung cancer presenting as a giant tumor of the thoracic wall
J. Marco Schnatera,
Rien E. Elandb,
Frans van der Straatenc,
Peter W. Plaisiera*
a Department of Surgery, Albert Schweitzer Hospital, NL-3300 AK Dordrecht, The Netherlands
b Department of Pulmonology, Albert Schweitzer Hospital, NL-3300 AK Dordrecht, The Netherlands
c Department of Radiology, Albert Schweitzer Hospital, NL-3300 AK Dordrecht, The Netherlands
Received 25 November 2003;
received in revised form 24 January 2004;
accepted 28 January 2004.
* Corresponding author. Tel.: +31-78-654-1111; fax: +31-78-654-2264
e-mail: p.w.plaisier{at}asz.nl
Key Words: Lung cancer • Malignant tumor of the chest
A 70-year-old man presented with a giant painless, left-sided, thoracic mass (Fig. 1)
. Diagnostic imaging showed a large tumor with infiltration of the chest wall and erosion of adjacent ribs (Fig. 2a)
. Histology revealed a moderately differentiated adenocarcinoma of the lung (Fig. 2b). The patient refused any treatment and died at home 10 days later.
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Fig. 1. Patient with a fixed, left-sided, thoracic mass (diameter 13x17 cm) without enlarged locoregional lymph nodes.
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Fig. 2. (a) Antero-posterior chest X-ray and CT scan of the chest (inset) showing a large tumor in the left hemithorax with infiltration of the chest-wall and erosion of adjacent ribs. No enlarged lymph nodes in supraclavicular, parasternal, mediastinal and axillary regions were detected. (b) An H and E cross-section (25x) of the core biopsy showed irregular glands with hyperchromatic, anisokaryotic nuclei afloat within dens fibrous tissue. The immunohistochemical profile (BerEp4+, CEA+, Calretinin–) was consistent with adenocarcinoma, further typing was suggestive of a primary pulmonary location (CK 7, CK 8, TTF1+, PSA–) of the tumor.
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Acknowledgments
The authors wish to thank Thea Teune for reviewing the histology.
