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Thymic carcinoma associated with acute monocyte leukemia (AMoL) and a history of choriocarcinoma was diagnosed in a 58-year-old female. We found no other such case in a literature search. She was first treated with DCMP therapy: daunorubicin, cytosine arabinoside, 6MP-riboside, and prednisolone against AMoL. After induction chemotherapy, complete AMoL remission was attained. Chest CT scan after chemotherapy revealed regression of the mediastinal tumor. Resection of the tumor included the left upper lobe of the lung, phrenic nerve and pericardium. Pathological diagnosis showed poorly or moderately differentiated squamous cell carcinoma. Although the patient died of pneumonia during chemotherapy for relapsed AMoL, chest X-ray and CT revealed no recurrence of the mediastinal tumor after the original operation. Judging from this case and other successful cases of chemotherapy, we feel that intensive chemotherapy may be a beneficial strategy against thymic carcinoma.

The indication for sleeve lobectomy of the middle lobe is limited, because the frequency of cancer occupying both the middle lobe and its bifurcation is low and the more commonly used middle and lower lobectomy is an alternate procedure. However, if a patient has accompanying cardiopulmonary restriction, lung preservation is paramount. We present a patient with hilar lung cancer (TisN0M0) associated with progressive cardiomyopathy, who underwent sleeve lobectomy of the middle lobe; the cancer took a favorable course.

A 38-year-old woman with metastatic choriocarcinoma of the lung had been treated for a hydatidiform mole nine years previously. During the interval she had conceived and given birth to a child. Following lobectomy she has been metastasis-free for five years.

Primary mediastinal seminoma is an uncommon tumor usually located in the anterior mediastinum. The majority of cases occur in young males. We report here an extremely rare case of a 69-year-old male with primary seminoma in the middle mediastinum. The patient had no complaints, but an abnormal shadow was seen in a routine chest X-ray. We performed a tumorectomy in the middle mediastinum, a thymectomy and an orchidectomy and added postoperative chemotherapy. It seems that the tumor was not associated with the thymus, so we believe the tumor did not stem from the embryonic thymus. Our case demonstrated that mediastinal seminoma does not always occur in the anterior mediastinum of young males. Although this case is rare, seminoma should be included among the possible diagnoses of a middle mediastinal mass.

A 47-year-old male patient underwent Bentall's modification with total arch replacement owing to type A acute dissection. Mediastinitis and composite graft infection occurred 3 weeks after the operation. Extensive debridement and irrigation followed by omental wrapping without graft removal were performed and the patient was successfully cured.

We report a case of a 61-year-old man with a tiny thymic carcinoma completely surrounded by thymic tissue. First, a thoracoscopic resection of about two-thirds of the right inferior part of the thymus containing the tumor was performed to obtain the histological diagnosis. Frozen-section diagnosis at operation revealed a thymic carcinoma. Therefore we performed a median sternotomy and resected the remnant of the thymus. A tiny thymic carcinoma completely surrounded by thymic tissue is extremely rare. In this case, as the tumor was tiny and there was a homogeneous mass without a thymoma-like component, we concluded that this tumor was de novo.

The present paper reports a 28-year-old male with an asymptomaticmalignant Triton tumor of the lung. Chest radiographs revealed a mass in the left hilum. The left lower lobe including the tumor and the mediastinal lymph node was resected. There was no metastasis or tumor recurrence during the one-year period following the surgical procedure. To our knowledge, this is the first case report of a primary pulmonary malignant Triton tumor.