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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2004 December;43(4):177-82
Primary lung cancer and ipsilateral adrenal lesion: Homochronous resection through a transthoracic transdiaphragmatic approach
Kotoulas C., Foroulis C., Psathakis K., Lioulias A.
Aim. Simultaneous primary lung cancer and ipsilateral adrenal lesion present a therapeutic challenge to the thoracic surgeon. The aim of the study is to present the homochronous resection through a transthoracic transdiaphragmatic approach as a diagnostic and therapeutic procedure in these cases.
Methods. We present our experience in the surgical management of 6 patients (5 males and 1 female) with a left-sided lung cancer and an ipsilateral adrenal lesion. A transthoracic transdiaphragmatic approach was used to resect the primary lung tumor and establish the definitive diagnosis or completely remove, at the same time, the adrenal lesion.
Results. Three adrenal lesions introduced carcinomas. TNM stage was IB in 2 patients, IIB in 1 and IV in the other 3. There was no perioperative morbidity or mortality. Average hospital stay was 8±1.6 days. There are 5 patients alive and the mean follow-up is 19.4±15.1 months (4-36).
Conclusion. In cases of simultaneous lung cancer and ipsilateral adrenal lesion, the transthoracic transdiaphragmatic approach for homochronous resection of both lesions is preferable as it is not only diagnostic but also therapeutic, while it requires a single session of anesthesia, without major complications, and is cost saving.