Evolución posquirúrgica de 7 sarcomas pulmonares primitivos

Corpa-Rodríguez, M.E.; Mayoralas-Alises, S.; García-Sánchez, J.; Gil-Alonso, J.L.; Díaz-Agero, P.; Casillas-Pajuelo, M.

doi:10.1157/13081253

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Los sarcomas primitivos pulmonares son muy raros, pero no los metastásicos. Se analizaron 7 sarcomas primaries operados en nuestro servicio entre 1985 y 2001. El diagnóstico histológico preoperatorio fue correcto en 2 pacientes. Se realizó cirugía en todos. En uno se amplió la resección a aurícula izquierda, en otro a pared torácica y en otros 2 se extirpó pleura parietal. Se consideró cirugía completa en 6 casos. En el estudio histológico 4 fueron fibrohistiocitomas malignos, uno angiosarcoma, uno sarcoma osteogénico y uno sarcoma indiferenciado. Las adenopatías extirpadas estaban libres de tumor.

Se hizo tratamiento complementario en 3 pacientes. En los 3 de mayor supervivencia se realizó sólo cirugía, con un seguimiento de 16, 9 y 4 años, respectivamente. Uno tiene actualmente una recidiva tumoral nodular en pulmón único. En cuanto a los fallecidos, 3 murieron antes de un año y otro después de 24 meses de evolución.

En conclusión, la cirugía en los sarcomas pulmonares primitivos puede conseguir una elevada supervivencia.

Palabras clave:

Sarcomas pulmonares

Fibrohistiocitoma maligno

Angiosarcoma

Unlike lung metastases of extrapulmonary sarcomas, primary sarcoma of the lung is very rare. We analyzed 7 primary sarcomas treated surgically in Hospital Universitario La Paz, Madrid, Spain between 1985 and 2001. Preoperative histologic diagnosis was correct for 2 patients. Surgery was performed in all 7 patients. Resection was extended to the left atrium in 1 patient, to the chest wall in another, and the parietal pleura were removed from 2 others. Surgical resection was considered complete in 6 cases. Histology revealed 4 cases of malignant fibrous histiocytoma, 1 angiosarcoma, 1 osteogenic sarcoma, and 1 undifferentiated sarcoma. Enlarged lymph nodes removed during surgery were tumor free.

Three patients received complementary treatment. The 3 longest-surviving patients were treated with surgery alone; at the end of the study, these patients remained alive 16, 9, and 4 years after surgery. One patient has a recurrent lymph node tumor in a single lung. Three patients died within 1 year and another died 24 months after surgery. In conclusion, surgical treatment of primary sarcoma of the lung can achieve good survival.

Key words:

Lung sarcoma

Malignant fibrous histiocytoma

Angiosarcoma

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