Invasive mucinous adenocarcinoma of the lung arising in a type 1 congenital pulmonary airway malformation in a 68-year-old patient: a case report

Concomitance of Pericardial Tamponade and Pulmonary Embolism in an Invasive Mucinous Lung Adenocarcinoma with Atypical Presentation: Diagnostic and Therapeutic Pitfalls-Case Report and Literature Review

The invasive mucinous adenocarcinoma of the lungs (LIMA) is an uncommon histological subtype of the mucinous adenocarcinoma. In this article, we present the case of a patient with a very high cardiovascular risk profile, diagnosed with LIMA, pericardial tamponade due to secondary dissemination, and pulmonary embolism, whose management rouses many challenges. Despite receiving the correct anticoagulant and antiaggregant therapy, our patient developed repeated acute major cardiovascular events leading to a fatal outcome. To gather additional information on LIMA and the above cluster of pathologies, we performed the first research of the international medical literature for scientific articles published in the last eight years on PubMed, ResearchGate, Clarivate, and Google Scholar. As the first literature research failed to identify any case similar to our patient, we performed a second study of the same databases for subjects with lung adenocarcinoma instead of LIMA and the same comorbidities, and we found 10 cases. LIMA is a less frequent type of adenocarcinoma, with polymorphic radiologic appearances on the chest computed tomography, frequently mimicking pneumonia, and thus delaying the diagnosis and therapy. It has a worse prognosis and higher mortality than the common adenocarcinoma, but information on its secondary dissemination and complications is still required.

Major surgical conditions of childhood and their lifelong implications: comprehensive review

BACKGROUND

In recent decades, the survival of children with congenital anomalies and paediatric cancer has improved dramatically such that there has been a steady shift towards understanding their lifelong health outcomes. Paediatric surgeons will actively manage such conditions in childhood and adolescence, however, adult surgeons must later care for these 'grown-ups' in adulthood. This article aims to highlight some of those rare disorders encountered by paediatric surgeons requiring long-term follow-up, their management in childhood and their survivorship impact, in order that the adult specialist may be better equipped with skills and knowledge to manage these patients into adulthood.

METHODS

A comprehensive literature review was performed to identify relevant publications. Research studies, review articles and guidelines were sought, focusing on the paediatric management and long-term outcomes of surgical conditions of childhood. The article has been written for adult surgeon readership.

RESULTS

This article describes the aforementioned conditions, their management in childhood and their lifelong implications, including: oesophageal atresia, tracheo-oesophageal fistula, malrotation, short bowel syndrome, duodenal atresia, gastroschisis, exomphalos, choledochal malformations, biliary atresia, Hirschsprung disease, anorectal malformations, congenital diaphragmatic hernia, congenital lung lesions and paediatric cancer.

CONCLUSION

The increasing survivorship of children affected by surgical conditions will translate into a growing population of adults with lifelong conditions and specialist healthcare needs. The importance of transition from childhood to adulthood is becoming realized. It is hoped that this timely review will enthuse the readership to offer care for such vulnerable patients, and to collaborate with paediatric surgeons in providing successful and seamless transitional care.

Clinical Image Feature Analysis and Diagnostic Efficacy Evaluation of Pulmonary Ultrasound in the Diagnosis of Congenital Pulmonary Airway Malformations in Children: Based on a Single Center, Retrospective Cohort Study

Objective

A single center, retrospective cohort study was conducted to analyze the clinical image features and diagnostic efficiency of pulmonary ultrasound in the diagnosis of congenital pulmonary airway malformations (CPAMs) in children.

Methods

The starting and ending time of this study is from May 2019 to December 2021. This study included 200 children with CPAM diagnosed by prenatal ultrasound and postpartum CT imaging (aged from 1 hour to 3 years), including 103 males and 97 females. All of them were diagnosed by fetal ultrasound and were examined by chest X-ray (CXR), chest CT, and lung ultrasound (LUS). The clinical image characteristics and diagnostic efficiency of CXR, chest CT, and LUS in the diagnosis of CPAM in children were analyzed.

Results

200 lesions were limited to single lung, and the most common were right lower lobe, right lower lobe in 80 cases (40.0%), left lower lobe in 60 cases (30.0%), right upper lobe in 30 cases (15.0%), left upper lobe in 20 cases (10.0%), and right middle lobe in 10 cases (5.0%). Among the 200 cases of preoperative CT examination, 196 cases (98.00%) showed lesions and confirmed diagnosis, and 4 cases were missed. Chest X-ray showed multiple focal circular low-density shadow in the right lung, and the heart shadow and mediastinum moved slightly to the left. CXR showed multiple cystic transparent shadows in the left lower lung and slightly to the right of the mediastinum and heart. CXR showed multiple balloon cavities of different sizes in the right lung field, and the mediastinum and heart shadow shifted to the left. The direct signs of LUS (including single or multiple cystic lesions) were not significantly different from those of CXR, but the indirect signs were significantly higher than those of CXR.

Conclusion

The most common CT findings of CPAM in children are cystic lesions, especially polycystic lesions, while LUS images of CPAM in children are various. LUS is a noninvasive and nonradiological examination method, which is easy to operate and repeat. LUS can be used for preliminary qualitative screening of CPAM in children, and the diagnostic value of indirect signs of LUS is better than that of CXR.