Abstracts/ Lung Cancer II (1994) 123-150 137

Childhood primary puhonary neoplasms Hancock BJ, Di Lorenxo M, Youssef S, Yaxbeck S, Marcotte J-E, Collin P- P. Hopital Sainte-Justine, 3175 Core Sainte-Catherine, Montreal, Que. H3T lC5. Pediatr Surg 1993;28: 11334.

Nine children (6 boys, 3 girls) were diagnosed with a primary endobmnchial or pulmonary parcnchymal neoplasm. The average age at diagnosis was 9 years. Presenting complaints included cough (7), fever (5), pulmonary infection (3), respiratory distress (3), weight loss (2). pain (2). and hemoptysis (1). Pulmonary x-rays showed persistent atelectaais, pneumonic infiltrates or mass lesions. A computed tomography scan was performed in 8. Five of six endobronchial tumors were diagnosed with bronchoscopy and biopsy. Treatment consisted of thoracotomy and pulmonary resection in 7 cases and laser resection in 2. The pathologic diagnoses were bronchial carcinoid (3), bronchial mucoepidermoid carcinoma (1) inflammatory pseudotumor (plasma cell granuloma) of the bronchus (2) and of the lung parenchyma (l), fibrosarcoma (l), and rhabdomyosarcoma (1). Postoperative chemo- therapy wasgivenonly tothepatimtwithpulmonaryrhabdomyosarcoms; this child died. One child has developed a local recurrence while 7 children are alive and free of disease at an average of 2.4 years post- resection. Pulmonary neoplasms are unusual in the pediatric age group and represent a wide spectrum of pathology. Including the present series, 383 tumors have been described. Seventy-six percent were malignant. Early investigation and surgical intervention are essential in children with persistent pulmonary symptoms or x-ray abnormalities. In most cases, the prognosis is excellent with complete surgical resection; however, malignancies other than bronchial adenoma are associated with significant mortality.

Interruption ofaortic flow between the thoracicand abdominal aorta with development of collateral circulation secondary to broncbogenic carcinoma Shih W-J, Wietzbinski B, Magoun S. Nuclear Medicine Service, Department of VA Medical Center, Kentucky University Medical Center, Lexington, KY. Clin Nucl. f&d 1993; 18:799-800.

Radionuclide demonstration of collateral circulation resulting from venous occlusion (such as superior vena cava, inferior vena cava, or femoral vein) has been well documented. The article reports that a patient’s first pnss radionuclide study of the thomcoabdominal region showed interruption of normal flow between the thoracic and abdominal aorta with gradual filling-m of the abdominal aorta with multiple collateral vessels in the thoracoabdominal and pelvic regions. The subsequent CT scan of the chest and abdomen demonstrated a large right media&al mass invading the major vessels inferior to the carina. The mass was found to be a poorly differentiated carcinoma.

Sensory disorder of the chest as presenting symptom of lung cancer Marangoni C, Lacerenra M, Forrnaglio F, Smirne S, Marchettini P. Istituto Scientt&o H San Rt@%aek, Centro di Medicina de1 Dokre, Via Prinetti 29, 20127 Milan. J Nemo1 Neumsurg Psychiatry 1993;56: 10334.

Four patients with Pancoast’s syndrome had burning pain in the axilla and abnormal sensation in the intercostobrachial nerve territory. The intercostobracbial nerve is the first component of the brachial plexus to be invaded by lung tumours.

Association of miliary lung metastases and bone metastases in bronchogenic carcinoma Umeki S. Respiratory Diseases/Medicine, Kawasaki Medical School, Kurashiki. Okayama 701-01. Cheat 1993;104:948-950.

Five cases of miliary lung metastasis among 630 patients with

bronchogenic carcinoma were investigated. Bone metastuses from the bmnchogenic carcinoma were observed in 246 (39 percent) of these 630 patients, and the five were all patients in this latter group. These results suggest that bronchogeniccsrcinoma may produce miliary lung metastasis through its bone metastasis.

Pulmonary perfusion scan in the evaluation of the local extension in lung cancer Cangemi V, Volpino P, D’Andres N, Tomassini R. Via Squarciakpo 19/A, 00162 Roma. Chirurgia (Turin) 1993;6:363-5.

The relationship between major defect of the perfusion as seen by perfusion lung scan and local extension of neoplastic lesion (invasion of the mcdiastinum and great vessels or specific involvement ofpulmonary artery) was studied in 35 consecutive patients with bronchogenic carcinoma. Major perfusion defect was present in 6 of the 7 cases with pulmonary artery involvement and in 8 of the 11 cases with invasion of the mediastinum and other great vessels; besides it was associated with a condition of inoperability in 75% of the cases. Among patients in whom a larger defect was not present only 2 1.1% had such extension of the disease, while 78.9% was submitted to resection. The sensibility, specificity and accuracy of the perfusion scanning was 77.7-88.2- 82.8% in relation to the spread of the mediastinum and 85.7-64.2- 68.5% in relation to the specific pulmonary artery involvement.

The role of iodinel23-Tyr+octreotide scintigraphy in the staging of small-cell lung cancer Leitha T, Meghdadi S, Studnicka M, Wolxt M, Marosi C, Angelberger P et al. Universiry Clin. of Nuclear Medicine, University Vienna, Waehringer Guertel18-20, lOXI Vienna. J Nucl Med 1993;34: 1397- 1402.

The purpose of this study is to investigate the role of lnI-Tyr-3- octrcotide scintigmphy in staging small-cell lung cancer (SCLC), its efficacy for the discrimination of limited and extensive di- stages and its regional sensitivity for different metastatic locations. Twenty Patients with histologically confirmed SCLC and 50 radiologically staged tumor sites were investigated by an imaging protocol including dynamic (O-30 min p.i.), static (30 min, 90 min, 4 hr, 24 hr p.i.) and SPECT (90 min pi.) studies. The primary tumor site was visualixed in 84 96, whereas the best delineation was noted in early planar (15-30 min p.i.)andSPECTstudies,duetoarapidlydecreasingtumor-to-backgmund ratio. Lymph node metastases were seen in 73 46, but SPECT was needed for anatomical localization. All three adrenal metastases could be identified in sequential planar images. One clinically unsuspected brain metastasis was seen, whereas a second clinically overt metastasis was not visualized. The global and regional sensitivity for liver and bone metastases was unsatisfactory. In summary, 78% (719) of the patients with extensive disease were correctly identified by scintigraphy alone. We conclude that “‘I-Tyr-3octreotide scintigraphy is a substantial tool in the staging work-up of SCLC if it is performed initially to allow fast identificationofpatirattswithextcnsivediseasestagesandsaveadditional radiological or invasive examinations. Yet, ‘r’)I-Tyr-3-octreotide scintigmphy camiot substitute liver sonography or conventional bone scanning in patients who have no scintigraphic evidence of distant tumor spread.

Lung tumor metastasis to breast detected by lluorine-lg- fluorodeoxyglucose PET Hunter GJ, Choi NC, McLoud TC, Fischman AJ. Dept. OfRadiology, MGH-NMR Center, Massachusetts General Hospital, 13th St., Charlestown Navy Yard, Boston, MAO2129. J Nucl Med 1993;34: 1571- 3.

We report a case of breast metastasis from a large-cell bronchogenic