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688

SURGINBEDLR AS A DIAGNOSTIC AND THERAPEUTIC TOOL FOR PLEURAL EFFUSION

Jung-sen Liu Dept. of Surgery, Cathay General Hospital Taipei, Taiwan, R.O.C. Surgineedle was first developed by the United States Surgical Corporation. It consists of one 14-gauge pneumoperitoneum needle with a spring-loaded blunt stylet safety mechanism similar in function to a Veress needle. It is usually used as a puncture needle for inflation of CO, to produce pneumoperitoneum at the beginning of laparoscopy. In our application of the needle to patients with pleural effusion for diagnostic and therapeutic purposes, the Surgineedle was connected to a three-way connector, a SO ml syringe and an extension tube. This tool was used to obtain pleural effusion for cytological studies in 18 patients and to drain the effusion therapeutically in 12 lung cancer patients. Complications of 30 applications included one mild pneumothorax and one mild subcutaneous emphysema. We failed to obtain the effusion in one patient showing encapsulation of the effusion. The safety mechanism of this tool can prevent the needle from injuring the lung parenchyma hence avoiding traumatic pneumothorax or hemothorax during the procedure.

FOURSURGICAL CASES OFTHYMIC CARCINOMA T. K-to, Y. Saitoh, M. Lhnenoto, and H. Imamura Department of Thoracic Surgery, Kansai Medical University, Osaka, Japan

Though various kinds of tumors are found in thymus, primary thymic carcinoma is very rare. Neither the origin and the nature of the tutnor nor the management and the prognosis are still well understood. Since 1975, 130 surgical cases of xediastinal tumors were operated in our hospital, and among them, only 4 cases of thymic carcincma were found. In all cases, the patients were male at the age of 12-64 Years. In all these cases, operative therapy followed by irradiation or chmtherapy. Among these cases mentioned above, 3 of them, ttmmn- resectcany was performed including thyrnic parenchima with or without 1-innominate vein, phrenic nerve, pericardim, and lung. Histological findings revealed squamous cell carcimcxna in 2 cases and undifferentiated carcinoma in the other 2 cases. Thymic carcinoma especially in child is very rare as only 2 cases were reported previously. We had a case of thymic carcinoma at 12-year-old boy and the tumor resection was performed with the right lobe of the thymus. Histology showed it as undifferentiated carcinana. After surgery radiotherapy was carried out as adjuvant therapy. After the operation the CD4/C!DS ratio was found normal, indicating that T cell differentiation was not affected and the patient is still now in healthy status.

Bronchogenic carcinoma producing human chorionic

K. Kikuchil gonadotro in

M. Watanabe P 1

, K. Kobayashil, T. Ishihara , S. Itoh2, E. Takashlta2 Department of Surgeryl, Department of Clinical Laboratories2, School of Medicine, Keio University, Tokyo, Japan

It is known that bronchogenic carcinoma produces ectopic hormones. Extensive endocrine studies were performed on patients with a bronchogenic carcinoma which were found to be producing abnormal amounts of gonadotropin. We estimated HCG, HCG-I3 levels in consecutive 110 patients with lung cancer admitted to Keio University Hospital. In 3 patients (2.7%), HCG level was higher than normal level, in 8 patients (7.3X), HCG-B level was elevated. In only 2 patients HCG and HCG-13 were simultaneously elevated. Histological types were; adenocarcinoma in 3 patients, squamous cell carcinoma in 2, large cell carcinoma in 2, choriocarcinoma of the lung in one, unclassified carcinoma in one. Clinical TNM stage were; stage I in 2 patients, stage III in 2, stage IV in 5.

Our study showed bronchogenic carcinoma producing HCG or HCG-13 was not so rare than that had been reported.

690

RETROSPECTIVE STUDY OF 72 PATIENTS WITH BRAIN METAsTAsEs (BM) SECONDARY TO LUNG CANCER (LC)

E. TEIXEIRAt, F. Mascarenhas*, J. Miguensft, M. Sousa+, T. Guiomar*, L. Albuquerque++, R. Sotto-Mayor+, J.MaCa nitat and M. Freitas e Costa+. t Service de Doenoas Pulmonares, CnL3-INIC "Unidade de Radioterapia, ++ Service de Neurocirurgia (Hospital de Santa Maria Lisboa PORTUGAL).

In LC, the rate of BM is very great. With the present retrospective study, we pretend estimate our experience about this subject. We review 72 cases of patients(pts) with histological and/or cytological diagnosis of LC whose evolution have shown somewhere, the appearance of BM. 60 pts (83.3%) were males, the mean agewas59.12 years (with a range of 34 to 76 years) and there was a preponderance of adenocarcinoma (33.3%) and epidermoid carcinoma (27.8%). In 37 pts (51.4%), the BM were the alarm signal of LC. In the others, as a rule,BM appeared 198.6 days after have seen made the diagnosis of LC. All the pts have made CT scans of brain that were dia- gnostic in 69 (95.8%) but in the 3 others, the diagnosis only was possible by NMR. In 39 pts there was more than one metastases. The treatment rested in craneocerebral surgery in 12 pts (16.7%), followed by cranialirradia tion in 9 of them; 29 pts (40.3%) were submitted only to cranial irradiation, 5 pts to cranial irradiation with chemotherapy and in 21 pts (29.2%) was dane only support therapy. We correlated the histologic type the therapy and the survival.