Benign metastasizing leiomyoma (BML) is a rare disease that occurs in middle-aged women with a history of uterine myomas. The most common location of BML is the lungs.We report the case of a 44-year-old obese woman (BMI 45.5) who underwent surgery to remove uterine leiomyomata and then continued to take a drug containing the hormone estradiol for a period of 15 years. Computed tomography chest examinations revealed multiple size nodules of varying size in both lungs. Videothoracoscopy and right thoracotomy was performed, and a few nodules were enucleated from each lobe of the right lung. Postoperative histopathological examination revealed benign metastasizing leiomyoma staining positive for estrogen and progesterone receptors (ER+, PR+). Because of the hormonally dependent cell proliferation, the previously used hormonal drug was discontinued. Treatment with a gonadotropin-releasing hormone analog was included, yielding radiological stabilization of the lung lesions.

Background: The new classification and terminology concerning neuroendocrine tumors, according to the European Neuroendocrine Tumor Society (ENETS) guidelines, were not universally accepted for bronchopulmonary carcinoids. That is why the term "carcinoid" is still being used in its traditional meaning. Precise identification of bronchopulmonary carcinoid subtypes constitutes an important prognostic factor. Aim of the study: The aim of the study was to present the results of bronchopulmonary carcinoid surgical treatment conducted at the Department of Thoracic Surgery in Bystra, to assess the surgery material in accordance with the WHO 1999 (Travis) classification, and to compare the clinical courses of typical and atypical carcinoid tumors. Material and methods: The analysis included 159 patients aged 18-77, treated surgically due to bronchopulmonary carcinoids in the years 1990-2011. Reassessment of histological preparations was carried out according to the WHO 1999 (Travis) and International Association for the Study of Lung Cancer (IASLC) classification; check-ups of the treated patients were performed as well. Disease-free interval (DFI) and overall survival were assessed with the Kaplan-Meier method; the clinical course of typical and atypical carcinoids was compared. Results: As a result of the histological reassessment, 142 patients (88.3%) were diagnosed with typical carcinoids, and 17 patients (11.7%) with atypical carcinoids. During the followup period, local disease recurrence occurred in 8 (4.9%) patients, distant metastases in 13 (8.2%) patients. There were 26 (16.4%) instances of death -2 because of other malignant neoplasms. The DFI median (p = 0.00003) and overall survival (p < 0.00001) were significantly longer in patients with typical carcinoids than in patients with atypical types of the tumor. Conclusions: The histological subtype of a bronchopulmonary carcinoid tumor is the dominant prognostic factor in assessing the DFI and the 5-year survival after surgery. Key words: typical carcinoid, atypical carcinoid, neuroendocrine tumors. StreszczenieWstęp: Wprowadzona nowa klasyfikacja i terminologia guzów neuroendokrynnych zgodnie z wytycznymi European Neuroendocrine Tumor Society (ENETS) nie została powszechnie przyjęta w odniesieniu do rakowiaka oskrzelowo-płucnego i nadal używa się określenia "rakowiak" w tradycyjnym ujęciu. Dokładna identyfikacja podtypu rakowiaka oskrzelowo-płucnego ma istotne znaczenie dla rokowania. Cel pracy: Przedstawienie wyników leczenia operacyjnego rakowiaka oskrzelowo-płucnego na Oddziale Chirurgii Klatki Piersiowej w Bystrej, ocena histologiczna materiału operacyjnego zgodnie z klasyfikacją WHO 1999 -Travisa, a także porównanie przebiegu klinicznego rakowiaka typowego i atypowego. Materiał i metody: Analizie poddano 159 chorych w wieku 18-77 lat operowanych z powodu rakowiaka oskrzelowo-płucnego w latach 1990-2011. Przeprowadzono ponowną ocenę preparatów histologicznych na podstawie materiału archiwalnego zgodnie z klasyfikacją WHO 1999 -Travis i IASCL oraz b...

StreszczeniePotworniak jest guzem wywodzącym się z komórek rozrodczych. Najczęściej lokalizuje się w gonadach, w śródpiersiu stanowi ok. 15% guzów tej okolicy. Zwykle rozpoznawany jest przypadkowo, najczęściej u młodych dorosłych. Charakteryzuje się powolnym, stałym wzrostem i może osiągać znaczne rozmiary. Autorzy opisują przypadek młodej kobiety, u której wykryto guz śródpiersia przedniego. Wykonano u niej mediastinotomię przymostkową i pobrano wycinki z guza. W okresie okołooperacyjnym doszło do wytworzenia przetoki wzdłuż rany po mediastinotomii łączącej światło guza ze zbiornikiem w tkankach miękkich ściany klatki piersiowej. Chora wymagała nakłuć tego zbiornika i ewakuowania płynu produkowanego przez tkanki wydzielnicze guza. Na podstawie pobranych wycinków rozpoznano potworniaka dojrzałego i ostatecznie guz śródpiersia usunięto. Przebieg po usunięciu potworniaka był niepowikłany. Słowa kluczowe: potworniak, śródpiersie, powikłanie. AbstractTeratoma is a tumor originating from reproductive cells. They are mostly localized in gonads, in the mediastinum, it constitutes about 15% of tumors in this area. It is usually diagnosed incidentally, mostly among young adults. The authors describe the case of a young woman with the detected tumor in the anterior mediastinum. She has an operation of parasternal mediastinotomy, during which, the fragments of the tumor were collected. In the perioperative period, the fistula along the wound has developed, joining the light of a tumor with the reservoir in the soft tissues of a chest wall. The punctures of this reservoir and the release of a liquid produced by the secretory tissues of a tumor were necessary for the patient. From the collected fragments a full-grown teratoma has been identified and finally the anterior mediastinum has been removed. After the removal of the teratoma there were no further complications.