Lungs are one of most metastatic areas for primitive neuroectodermal tumor (PNET), however primary pulmonary PNET is extremely rare. Here we present a case of a 58-year-old male patient with a tumor in the right lung that originated from the lung but not from chest wall. Patient was diagnosed with PNET following histological and immunohistochemical examination of CT-guided percutaneous tru-cut needle biopsy and no distant metastasis were detected in PET-CT scan. As advised recently in published literature, surgical resection following neoadjuvant chemotherapy protocol is preferred in the treatment of our patient as it has better success of complete resection leading to higher 5-year survival rates. Although primary pulmonary PNET is uncommon, it should be taken into account and complete surgical resection should be aimed as treatment to achieve higher survival rates.
Dear Editor-in-Chief, Anjana et al. reported in a recent study that, over a 9-year follow-up period, diabetic subjects with irregular or infrequent doctor visits had almost double the risk of glycemic burden, retinopathy and nephropathy compared to those with regular follow-up. However, the authors observed a nonsignificant effect of a better diabetes management on the occurrence of coronary heart disease (CAD) and peripheral arterial diseases (PAD) [1]. This result was interesting, opposite to what we know, and the authors were not able to discuss this outcome successfully in their paper. However, upon reading the paper in detail, we needed to take attention of the readers to several methodological issues regarding the study.Several studies were previously published from the cohort which served as the patient source for the present work, and CAD and PAD data had already been reported separately (Article references 19 and 20). In the original trial for CAD frequency, presence of CAD was assessed in 84 % of subjects totally, by a resting 12-lead electrocardiogram using Minnesota coding by a single observer, or with a past self-report history of documented myocardial infarction [2]. Data related to PAD prevalence was also obtained from another study on the same cohort, in which Doppler ankle-brachial index measurement (ABI) was restricted to 50 % of the participants due to logistical reasons (authors' statement), reaching a total of 631 participants with a definite testing for PAD through ABI measurement [3]. Thus, because the definition of CAD patients was not robust in the first trial, and because only one half of the participants had evidence-based PAD workup in the second report, the present study with a so-called extended follow-up was most probably subject to incorrect classifications. Therefore, in such case, follow-up and outcome analyses may easily become inconclusive. Particular attention was also required for ABI testing in people with diabetes [4] when using to screen for PAD which is indeed more common in these patients [5].Moreover, Table 2 of the study reported CAD and PAD data as if all participants had both initial and outcome detections for CAD or PAD; however, missing data of 16 % for CAD and 50 % for PAD at initial assessment should not have been ignored at the final analyses.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.