We report a case of primary tracheal schwannoma in a 31-year-old woman. She had a previous history of follicular thyroid carcinoma treated surgically and Turner syndrome. In a follow-up computed tomography scan, we found a partially obstructing intraluminal tracheal tumor, which was confirmed by bronchoscopy. The patient was treated by surgical resection and primary tracheal anastomosis. The tumor was 14 mm in diameter, with an intact capsule. Histologic analysis revealed a Schwann cell origin tumor.
To date, the impact, timeline and duration of COVID‐19 pandemic remains unknown and more than ever it is necessary to provide safe pathways for cancer patients. Multiple triage systems for nonemergent surgical procedures have been published, but potentially curative cancer procedures are essential surgery rather than elective surgery. In the present and future scenario of our country, thoracic oncology teams may have the difficult decision of weighing the utility of surgical intervention against the risk for inadvertent COVID‐19 exposure for patients and medical staff. In consequence, traditional pathways of surgical care must be adjusted to reduce the risk of infection and the use of resources. It is recommended that all thoracic cancer patients should be offered treatment according to the accepted standard of care until shortage of services require a progressive reduction in surgical cases. Here, we present a consensus of recommendations discussed by a multidisciplinary panel of experts on thoracic oncology and based on the best available evidence, and hope it will provide a modifiable framework of guidance for local strategy planners in thoracic cancer care services in Mexico.
Key points
Significant findings of the study
This article provides recommendations to guarantee the continuity of surgical care for thoracic oncology cases during COVID‐19 pandemic, whilst maintaining the safety of patients and medical staff.
What this study adds
This guideline is the result of an expert consensus on thoracic surgical oncology with recommendations adapted to medical, economic and social realities of Mexico.
Size of thymomas should not be considered as a contraindication for surgical treatment. Our data suggest that extended surgery is feasible even in advanced cases and provides the best chance for cure. Complete resection remains as one of the most important prognostic factor in thymomas and is associated with prolonged DFS and OS.
Objetivo. Proporcionar recomendaciones para la detección temprana de pacientes con alto riesgo de desarrollar cáncer de pulmón (CP) en el primer nivel de atención y su referencia oportuna. Material y métodos. Se realizó una búsqueda detallada de la evidencia científica disponible para responder las preguntas de investigación clínica y se utilizó el Panel Delphi modificado para lograr un consenso entre expertos. Resultados. Se generaron 14 recomendaciones siguiendo los estándares de una GPC. Conclusión. El CP representa un problema de salud pública en México; por ello, esta guía establece recomendaciones que apoyan la toma de decisiones sobre la detección precoz y la referencia de pacientes con sospecha de CP en el primer nivel de atención.
The incidence of mediastinal teratomas is low, it’s important to recognize them between all the differential diagnoses for mediastinal tumors. The treatment is surgical resection.
We report a giant mature cystic teratoma of the mediastinum in a 40-year-old woman. She presented with dyspnea, flu-like symptoms during the previous 5 days. An x-ray complemented with a chest CT scan showed a heterogeneous extrapulmonary multiloculated and predominantly fluid density tumor located at the left side of the mediastinum. The patient underwent resection by video-assisted thoracic surgery (VATS). The tumor was 15 cm in diameter with a predominant cystic component. Histologic examination revealed a mature cystic teratoma.
Treatment of these tumors should attempt a complete resection. Open approaches are painful, require a longer recovery and are associated with higher morbidity. VATS has been used to treat these tumors, demonstrating the same effectiveness and advantages over open procedures.
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