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  • • Resectable lung metastases

    • -Osteogenic sarcoma

      -Soft-tissue sarcoma

      -Wilms tumor

    • Primary lung tumors

    • -Bronchial "adenoma": Malignant (most common)

      -Bronchogenic carcinoma (90% mortality rate)

      -Pulmonary blastoma, sarcomas, inflammatory pseudotumor (benign)

      -Hamartoma (benign)

    • Mediastinal tumors

    • -Neurogenic (posterior mediastinum, include neuroblastoma, ganglioneuroblastoma, and ganglioneuroma)

      -Neurofibroma, lymphoma, teratoma (anterior mediastinum)

    • Chest wall

    • -Ewing sarcoma

      -Chondrosarcoma

      -Liposarcoma

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Symptoms and Signs

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  • • Cough with sputum

    • Hemoptysis

    • Chest pain

    • Dyspnea

    • Fever

    • Postobstructive pneumonia

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Laboratory Findings

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  • • Leukocytosis

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Imaging Findings

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  • Chest film: Can identify mass

    Chest CT: Can identify various etiologies of chest mass and relative location

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  • • Evaluate for sites of primary disease

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  • • History and physical exam

    • Chest x-ray

    • Chest CT

    • Bronchoscopy for central lesions

    • Thoracoscopy and possible biopsy

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Surgery

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  • • Formal resection (wedge or lobectomy) indicated for nearly all of above etiologies or excision of mediastinal lesions

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Prognosis

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  • • Excellent for most pulmonary neoplasms

    • -Outcome better for neuroblastomas in chest than for those in abdomen

      -Bronchogenic carcinoma, 80% mortality

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References

Albanese CT, Rothenberg SS: Experience with 144 consecutive pediatric thoracoscopic lobectomies. J Laparoendosc Adv Surg Tech A 2007;17:339.41

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