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We have previously reported single-port thymectomy (SPT) through an infrasternal approach, a procedure in which the thymus is removed through a single port. The dual-port thymectomy procedure developed by adding another port to the single-port procedure has eliminated the risk of interference between forceps operated by both hands of the surgeon and has thereby significantly simplified operative procedures. This procedure provides the same operative field as that obtained by median sternotomy and has excellent maneuverability of devices. Therefore, the dual-port procedure can be used by surgeons who have not been sufficiently trained for SPT, as an alternative procedure in the event of experiencing technical difficulty during SPT, or as a new approach for thymectomy.

Epithelial-myoepithelial carcinoma (EMC) typically arises in the salivary glands, whereas EMC of the lung is an extremely rare histological form that originates from the bronchial glands. Although cavitation in primary lung cancer is not uncommon, to the best of our knowledge, a case of EMC with a cavitary lesion has not been reported to date. We herein describe a case of cavity-forming pulmonary EMC. A 72-year-old man was referred to our department due to a thickened cystic wall discovered in the upper lobe of the left lung and underwent thoracoscopic left upper lobectomy. Microscopically, the tumor was characterized by biphasic architecture, with glands surrounded by myoepithelial cells. The pathological diagnosis was EMC. The patient has remained in good health for 2 years postoperatively, without any evidence of recurrence. As regards the mechanism of cavity formation, it was hypothesized that the bronchial gland in the primary cystic lesion had been present 3 years prior to the development of the EMC, and grew to become a cavitary lesion. Therefore, although the mechanism of cavity formation remains to be elucidated, EMC of the lung may include a cavitary lesion.

We report a rare case of aspiration of a drug in a press‐through package (PTP) treated by not just pulling it but using a unique technique. A 73‐year‐old woman was referred to our department because of a persistent cough resulting from aspiration of a PTP. Flexible bronchoscopy identified the PTP in the trachea immediately above the carina. Just pulling the centre of the PTP edge with biopsy forceps could not move it, and we then rotated it by pulling the corner of the PTP edge to directly below the vocal cord. Passing over the vocal cord was difficult, which made us remove the bronchoscope and urge the patient to cough. These rotation techniques and voluntary coughing successfully removed the foreign body. This unique procedure may aid in the removal of a similar foreign body using a flexible bronchoscope forceps with insufficient grasping force.

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