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Sternal chondrosarcoma – a case report

01/2021 MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Michal Reška, Ph.D.; MUDr. Alena Berková, Ph.D.; MUDr. Vladimír Červeňák; prof. MUDr. Jiří Veselý, CSc.; MUDr. Zdeněk Dvořák, Ph.D.; MUDr. Tomáš Hanslík; MUDr. Adam Peštál, Ph.D.; MUDr. Vadym Prudius, Ph.D.; prof. MUDr. Ivan Čapov, CSc.
This case report presents the case of a 68-year-old man, who presented with slow-growing, slightly painful infiltration in the lower half of the sternum observed for two years. According to the performed computed tomography examination, a 7 * 6 * 6.5 cm infiltration of the middle part of the sternum was found. Lesion was extending 1 cm ventrally and 4 cm dorsally into the surrounding soft tissues. An open biopsy was performed with the finding of moderately differentiated (grade 2) conventional chondrosarcoma. Subsequently a multidisciplinary team composed of: the Musculoskeletal tumour committee of the Masaryk Oncology Institute in Brno, the 1st Orthopaedic Clinic of St. Anne's Faculty Hospital in Brno and the 1st Surgical Clinic of St. Anne's Faculty Hospital in Brno had referred the patient to plan and perform the surgical resection of the tumours lesion. A partial resection of the sternum with the tumor was performed, followed by reconstruction of the defect with two condensed polytetrafluoroethylene meshes using the so called „sandwich technique". Then the defect was strengthened using titanium splints and subsequently reconstructed by pectoralis major muscle flap. Definitive histology confirmed the finding of grade 2 conventional sternal chondrosarcoma.
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Mature teratoma of the thymus, random diagnosis in patient with ebrieta

06/2020 MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Alena Berková, Ph.D.; MUDr. Vladimír Červeňák; MUDr. Tomáš Hanslík; MUDr. Adam Peštál, Ph.D.; MUDr. Vadym Prudius, Ph.D.; prof. MUDr. Ivan Čapov, CSc.
The case report presents the case of the 23-year-old, an asthmatic man, being investigated for sudden shortness of breath, non-traumatic pain in the left shoulder and back after abuse alcohol. On the X-ray there was dilated mediastinum to the left side and in CT of chest was 4 * 5 * 5 cm size infiltration of anterior mediastinum. A pulmonary examination and fine needle biopsy were performed during the first hospitalization. In differential diagnosis was from low grade myofibroblastic sarcoma to mediastinal teratoma. It was indicated surgery revision. Procedure start uncomplicated diagnostic videothoracoscopy with frozen section and continuing to sternotomy extended to anterior left thoracotomy with extirpation on the mediastinal infiltration. Definitive histology confirms mature teratoma of the thymus.
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Atypical manifestation of non‑small cell lung carcinoma – case report

06/2020 MUDr. Tomáš Hanslík; MUDr. Zdeněk Chovanec, Ph.D.; MUDr. Alena Berková, Ph.D.; MUDr. Stanislav Špelda; MUDr. Michal Benej, Ph.D.; MUDr. Adam Peštál, Ph.D.; MUDr. Vadim Prudius, Ph.D.; prof. MUDr. Ivan Čapov, CSc.; MUDr. Vladimír Červeňák; MUDr. Tetiana Shatokhina
The authors acquaint the readers through a case report with a patient in whom non-small cell lung cancer manifested itself in an atypically bulky arching of the chest wall. Initially, it acted clinically and radiologically as chest wall sarcoma, as no tumorous infiltration of the lung parenchyma was evident. There was also a deposit of the right thyroid lobe of uncertain origin. Finally a number of immunohistochemical tests have brought about the resolution and diagnosis. According to genetic examination, the presence of a programmed cell death-ligand 1 (PD-L1) mutation was demonstrated in the cancer, and subsequently immunological therapy was used, which led to a significant regression of the tumor mass of the chest wall.
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Current options and recommendations for surgical treatment

05/2020 MUDr. Adam Peštál, Ph.D.
Surgical treatment is indicated for patients with lung carcinoma based on the stage of the disease and general health conditions of the patient. Surgical treatment for non-small-cell lung cancer (NSCLC) is suitable in stage I, II, and IIIA (TNM Classification), strictly individually can be considered in higher stages. Small cell lung cancer (SCLC) is suitable for surgical treatment only when T1—2(3), N0(1), M0 criteria are met. The goal of surgical intervention is to achieve a complete resection without leaving tumoral tissue, i.e. R0 resection. Surgical treatment of lung carcinoma consists also of systematic lymphadenectomy which means a complete removal of lung, hilar and ipsilateral mediastinal lymph nodes.
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