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A 36-year-old man having a left lower lobe laceration caused by penetrating chest wall injury was operated on 5 hours after Hanshin & Awaji Earthquake. At thoracotomy, significant destruction of the left lower lobe was observed. Therefore, we gave up repairing a lung, and performed left lower lobectomy, with a satisfactory outcome. Our hospital is located on 30 km south of seismic center, but the function of our hospital was not completely paralyzed. In Awaji island, emergent treatments were done satisfactorily.

In our department, half of 100 consecutive lung cancer resection cases were over the age of 70 years. In the same 100 patients, nineteen cases had multiple primary cancers. Sixteen cases had double, two cases had triple, one case had quadruple primary cancers. The incidence rate of multiple primary cancers involving the lung was 19%. This incidence of 19% is higher than the others ever reported in Japan. It was concluded, when lung cancer patients were elder, that there was increasment in the frequency of multiple cancer cases involving lung, and there was a high possibility of the occurrence of 2nd and 3rd primary cancers.

A 18-year-old man was admitted urgently complaining dyspnea, cyanosis and chest pain. The chest x-ray film revealed simultaneous bilateral pneumothorax. Chest drains were inserted immediately to the both chest cavities. On the 3 rd hospital day, radical operation for spontaneous pneumothorax with synchronous bilateral thoracotomies were performed through both axillary incision. Postoperative course was uneventful. The patient was discharged on the 8 th day after operation.

A case of localized pleural mesothelioma is reported. A 49-year-old man was operated for coin lesion detected on routine chest X-ray. A tumor arose from the visceral pleura of right lower lobe and was pedunculated. Size of the tumor was 4 x 3 x 3 cm. Cut surface of the tumor was solid and yellowish white. Pathological diagnosis was fibrous type of the pleural mesothelioma. The patient is well and has no sign of recurrence for three years. There are 123 cases of localized pleural mesothelioma including our case in Japan. Five in 78 cases which was diagnosed to be benign histologically at operation, had recurrence later. It is important to follow up strictly for long term.

A case of extraskeletal Ewing's sarcoma arising in the chest wall of a 15-year-old male is reported in this paper. His complaint was chest and back pain. Physical examination and laboratory data disclosed no abnormality. Radiographs and computed tomography revealed chest wall tumor, and resection of the tumor with a portion of the eighth rib was performed. Histologically, there was no involvement of the rib at all. The tumor tissue was composed of solidly packed tumor cells which were uniform in size and shape. Individual tumor cells were small, round-shaped, and had scanty, ill-defined cytoplasm. The diastase-digested, PAS positive material was found in the cytoplasm. NSE (neuron specific enolase) was positive, but EMA (epithelial membrane antigen) LCA (leucocyte common antigen), and keratin were negative. With these results, we got a diagnosis of extraskeletal Ewing's sarcoma. Combination chemotherapy with vincristine, cyclophosphamide, adriamycin, actinomycin D was administered after operation, and there is no evidence of recurrence after 12 months of follow-up.