Mediastinum Lymph Node Metastasis with Superior Vena Cava Syndrome

Background: Superior Vena Cava Syndrome (SVCS) is an increase in the upper body venous pressure caused by obstruction or stenosis of the Superior Vena Cava (SVC), which causes congestion of the head, face, upper limbs, neck and upper body. The main etiology has been reported to be tumors of the lungs or mediastinum, and aortic aneurysm.

Surgical tactics for benign bronchial and lung tumors

Aim: to identify the efficient surgical tactics in case of benign broncho-pulmonary tumors taking into account co-morbidities and possibilities of video-assisted thora- cic operations. Materials and methods. Among 133 pa- tients with benign tumors of the lungs and bronchi 128 (96%) had tumors of peripheral localization, 5 (4%) — of the central one. All patients with peripheral tumors were operated on. Charlson index was used to assess the co-morbidity. Results. In 120 (90.2%) patients tumors were diagnosed during routine Х-ray examination or casual check-up.6 (4.5%) patients showed clinical symp- toms. The average terms of observation of patients with peripheral tumors were 7.8 months (Me — 6, Q1 — 2, Q3 — 7), with the central ones — 13.3 months (Me — 5, Q1 — 3, Q3 — 8). In 4 cases central tumors were removed by endoscopy methods using electroresection and argon plasma coagulation. In one case a stent was inserted. More than 2/3 of patients had co-morbid pathologies. Charlson index in co-morbid patients was 2.4±1.4, in the group of patients elder than 70 years — 4.8±0.9. All patients with peripheral tumors were operated on. The video thoracoscopy approach was used in 56 (42.1%) pa- tients, thoracotomy — in 67 (50.4%), video-assisted mi- nithoracotomy — in 6 (4.5%). In 5.2% of cases thoracosco- py was converted to thoracotomy. All peripheral tumors were mesenchymal ones. Post-operative complications developed in 7 (5.5%) patients. There were no mortality. Conclusion. Peripheral benign tumors of the lungs are asymptomatic and require urgent surgery with an express histology test to rule out lung cancer. Central tumors are mostly removed by endoscopy. Video thoracoscopy is the most efficient method to remove peri pheral tumors. Conversion to thoracotomy is usually necessary in case of a small size and deep tumor localization.

High Mobility Group AT-Hook 2 (HMGA2) Oncogenicity in Mesenchymal and Epithelial Neoplasia

High mobility group AT-hook 2 (HMGA2) has been associated with increased cell proliferation and cell cycle dysregulation, leading to the ontogeny of varied tumor types and their metastatic potentials, a frequently used index of disease prognosis. In this review, we deepen our understanding of HMGA2 pathogenicity by exploring the mechanisms by which HMGA2 misexpression and ectopic expression induces mesenchymal and epithelial tumorigenesis respectively and distinguish the pathogenesis of benign from malignant mesenchymal tumors. Importantly, we highlight the regulatory role of let-7 microRNA family of tumor suppressors in determining HMGA2 misexpression events leading to tumor pathogenesis and focused on possible mechanisms by which HMGA2 could propagate lymphangioleiomyomatosis (LAM), benign mesenchymal tumors of the lungs. Lastly, we discuss potential therapeutic strategies for epithelial and mesenchymal tumorigenesis based on targeting the HMGA2 signaling pathway.

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Background: Νeuroendocrine tumors of the lungs are rare arising in the thymus and gastro-entero-pancreatic tract and belonging to foregut of neuroendocrine tumors. The aim of the present prospective study was to estimate the potential impact of single-photon emission computed tomography somatostatin receptor scintigraphy using 99mTc-Tektrotyd on diagnosis, treatment response, and prognosis in patients with neuroendocrine tumors of the lungs. Methods: Thirty-six patients with neuroendocrine tumors of the lungs were evaluated by using 99mTc-HYNIC-TOC scintigraphy. The scintigraphic results were compared to liver tissue uptake (Krenning score). Likewise, the functional imaging results were compared with biochemical indices including chromogranin A, neuroendocrine-specific enolase, and insulin-like growth factor 1 at the time of diagnosis (baseline) and disease progression. Results: The number of somatostatin receptors, expressed with Krenning score, did not show any correlation with the survival of patients both at baseline ( P = .08) and at disease progression ( P = .24), and scintigraphy results did not relate significantly to progression-free survival. Comparing the results of 99mTc-HYNIC-TOC scintigraphy according to the response of patients in the initial treatment, a statistically significant negative correlation was observed both in the first and in the second scintigraphy with patients’ response ( P = .001 and P < .001, respectively). The concentrations of biochemical markers were in accordance with scintigraphy results in the diagnosis. Conclusion: This study indicates that 99mTc-HYNIC-TOC scintigraphy appears to be a reliable, noninvasive technique for detection of primary neuroendocrine tumors and their locoregional or distant metastases, although it cannot be used as a neuroendocrine tumors of the lungs predictive technique.

Colorectal adenocarcinoma metastasizing to the oral mucosa of the upper jaw

Introduction. Metastases to the oral cavity are uncommon, accounting for only 1% of all oral malignant tumors. When they occur they mostly originate from primary tumors of the lungs, kidney, breast and prostate. Oral metastases from the primary colorectal carcinoma are much more infrequent. Case Outline. We present an unusual case of a 78-year-old man with a soft tissue oral metastasis originating from the primary colorectal carcinoma. The patient was referred to the Department of Otorhinolaryngology, Head and Neck Surgery with an intraoral mass on the right side of the maxilla. The diagnosis was confirmed by histopathologic examination and immunohistochemical analysis. Conclusion. Oral metastases occur rarely and often can mimic much more common benign lesions, therefore they should be considered as a possibility in a differential diagnosis.