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Introduction: Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules., Methods: Thirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis., Results: Of the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didn't find any loco-regional or distant recurrence in the patients studied., Conclusion: IPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role., (Copyright © 2021 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: This analysis aimed to evaluate perioperative outcomes of surgical resection following neoadjuvant treatment with chemotherapy plus nivolumab in resectable stage IIIA non-small-cell lung cancer., Methods: Eligible patients received neoadjuvant chemotherapy (paclitaxel + carboplatin) plus nivolumab for 3 cycles. Reassessment of the tumour was carried out after treatment and patients with at least stable disease as best response underwent pulmonary resection. After surgery, patients received adjuvant treatment with nivolumab for 1 year. Surgical data were collected from the NADIM database and patient charts were reviewed for additional surgical details., Results: Among 46 patients who received neoadjuvant treatment, 41 (89.1%) underwent surgery. Two patients rejected surgery and 3 did not fulfil resectability criteria. There were 35 lobectomies (85.3%), 3 of which were sleeve lobectomies (9.4%), 3 bilobectomies (7.3%) and 3 pneumonectomies (7.3%). Video-assisted thoracoscopy was the initial approach in 51.2% of cases, with a conversion rate of 19% (n = 4). There was no operative mortality at either 30 or 90 days. The most common complications were prolonged air leak (n = 8), pneumonia (n = 5) and arrhythmia (n = 4). Complete resection (R0) was achieved in all patients who underwent surgery, downstaging was observed in 37 patients (90.2%) and major pathological response in 34 patients (82.9%)., Conclusions: Surgical resection following induction therapy with chemotherapy plus nivolumab appears to be safe and offers appropriate oncological outcomes. Perioperative morbidity and mortality rates in our study were no higher than previously reported in this setting. A minimally invasive approach is, therefore, feasible., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Objectives: Atypical carcinoids are neuroendocrine neoplasms of intermediate degree and low frequency. The aim of this study is to analyse their clinical characteristics and the importance of different histopathological factors in their prognosis., Methods: Multicentre cooperative group EMETNE prospectively reviewed 153 patients operated on between 1998 and 2016 with diagnosis of atypical carcinoids. Clinical variables and histopathological features were assessed., Results: Mean age was 54.36 years, similar for both genders. Concerning pathological study, mean tumour size was 31.7 mm. Rosettes were presented in 17% of the cases and tumoural necrosis in 23.3%. The cell proliferation factor Ki-67 index was 10.7%. The 2- and 5-year overall survival rates were 95.8% and 88.9%, respectively. In the univariate study, statistically significant differences in survival were found for each of the categories of T, N and M factors. Mitotic index and quantification of expression of Ki-67 showed influence in overall survival, although without statistical significance. In the multivariate analysis, factors N, M and mitotic index behaved as independent prognostic factors related to survival. Median disease-free interval in the series was 163.35 months. In cases with loco-regional recurrence, 53% had positive hiliar or mediastinal nodal involvement at the time of the surgery. In the univariate analysis, we observed statistically significant differences in disease-free interval in patients with nodal involvement (P = 0.024) and non-anatomical resections (P = 0.04). Histological characteristics showed no statistically significant differences in disease-free interval., Conclusions: Lymph node involvement, the development of distant metastasis and mitotic index, more than Ki-67 determination, were shown as independent prognostic factors related to survival of these patients., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Introduction: Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules., Methods: Thirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis., Results: Of the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didńt find any loco-regional or distant recurrence in the patients studied., Conclusion: IPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role., (Copyright © 2021 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Several types of thoracic complications can be associated with severe acute pancreatitis. Some are very common, such as pleural effusion, whilst some others are very rare although life threatening, such as enzymatic mediastinitis (EM). Only a few cases of EM (when related to acute pancreatitis) have been described in the literature. Here we describe the case of a 76-year-old female who developed acute respiratory failure and atrial fibrillation during the postoperative period after an open pancreatic necrosectomy, due to an EM episode. The mediastinal collection was drained by thoracotomy, following an improvement of the patient's general condition. This is the first case of EM following surgical management for acute necrotizing pancreatitis. EM is a rare but life threatening complication that usually requires surgery.

Introduction: Age has been classically considered as a determining factor for the development of postoperative complications related to lung resection for bronchogenic carcinoma. The Postoperative Complications Study Group of the Spanish Society of Thoracic Surgery has promoted a registry to analyze this factor., Methods: A total of 3,307 patients who underwent any type of surgical resection for bronchogenic carcinoma have been systematically and prospectively recorded in any of the 24 units that are part of the group. Several variables related to comorbidity and age, as well as postoperative complications, were analyzed., Results: The mean age of patients was 65,44. Men were significantly more common than female. The most frequent complication was prolonged air leak, which was observed in more than one third of patients. In a univariant analysis, air leak presence and postsurgical atelectasis showed statistical association with patient age, when stratified in age groups. In a multivariate analysis, age was recognized as an independent prognostic factor in relation to air leak onset. However, this could not be confirmed for postoperative atelectasis., Conclusion: Age is a predisposing factor for the development of postoperative complications after lung resection. Other associated factors also influence the occurrence of these complications., (Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Thymolipoma is an uncommon benign neoplasm of the thymus composed of mature adipose and thymic tissue. The diagnosis of thymolipoma should be considered in the case of a mediastinal mass with fat density, especially if it is interspersed with strands of soft tissue attenuation on computed tomography scans. However, it is sometimes difficult to differentiate radiologically between a thymolipoma and other mediastinal fatty tumors. Here we present a patient with a huge mediastinal mass that proved to be a thymolipoma., (Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.)

Primary pulmonary angiosarcoma is a rare type of malignant vascular tumour characterised by proliferation of tumour cells with endothelial features. Up to date, only sixteen cases have been reported in English Literature. Treatment modalities vary from none to surgery, chemotherapeutic regimens, radiotherapy or immunotherapy, but none of them have been shown to be effective. Unfortunately, these tumours are usually very aggressive and overall mortality is very high. We present two cases of patients with a diagnosis of primary pulmonary angiosarcoma, the largest case series ever described, and a review of the scientific literature.

Objective: Bronchogenic carcinoma is the main cause of tumor-related deaths among men in Spain. The British Thoracic Society recommends that no longer than 4 weeks should pass from the moment a patient s name is placed on a waiting list until surgery takes place. We analyzed the influence of time until surgery on survival in patients with lung cancer., Patients and Methods: We operated on 108 patients diagnosed with bronchogenic carcinoma between January 1, 2001 and December 31, 2002. The time until surgery was defined by the date of application for care in our department until the moment of surgery., Results: The mean time on the waiting list was 56.87 days. No significant differences in mean wait-list times could be found in relation to tumor stage, type of surgery, patient age, or complete resection rate. The median survival in this patient series was 35 months. No significant differences in survival were found in relation to time until surgery in either the univariate or multivariate analysis. Pathologic stage, complete resection of the tumor, and patient age were prognostic factors., Conclusions: We found no evidence that delaying surgery affects survival in lung cancer patients. However, efforts should be made to reduce surgical wait-list times to bring them into line with the recommendations of scientific societies.

Pericarditis is the most frequent cardiac manifestation of systemic lupus erythematosus (SLE), but pericardial effusion rarely occurs as the only first clinical manifestation of SLE. We report the case of a male patient whose initial manifestation of lupus was a pericardial effusion. We comment on its clinical course and we reviewed in the medical literature different presenting features in SLE.

Typical carcinoid bronchial tumour is a well-known disease that, for years, was considered benign. Currently, it is classified within the group of neuro-endocrine lung tumours. It is a low-grade malignancy tumour with a capability of local and distant recurrence. Complete resection with mediastinal lymphadenectomy is the treatment-of-choice. There are, usually, long-term survivors, even in cases of recurrence or mediastinal node invasion. These patients could benefit from removal of recurrent or metastatic disease. We present, here, a case of a 19-years-old female diagnosed as having N1-bronchial typical carcinoid tumour. She underwent radical surgery, but with mediastinal recurrence and hepatic metastases. A new radical lung resection was performed, and a liver transplant was the therapy-of-choice for the metastatic lesion.