Thoracic surgery

Lung cancer is a malignancy of the lung that develops in the epithelial layer of the bronchi of varying caliber. Lung cancer is a worldwide medical and social problem. In developed countries, lung cancer is common and is the most common cause of death in cancer patients. According to the International Cancer Registry, there are one million new cases of lung cancer in the world each year and 60% of cancer deaths are caused by lung cancer. Lung cancer is more common in men than in women.

The main causes of lung cancer are carcinogens (such as tobacco smoke), ionizing radiation and viral infections. Their exposure causes cumulative changes in the DNA of the bronchial epithelium, and the more damaged the tissue, the higher the risk of developing cancer. Three types of metastasis are distinguished in the case of lung cancer:

  • Lymphogenic – metastatic invasion of the lymphatic system
  • Hematogenous – when tumor cells are carried in the blood
  • Implantation – when a tumor causes overgrowth into a surrounding structure.

The clinical presentation  of lung cancer depends on the localization of the primary focus. Central lung cancer – causes bronchial atelectasis, productive cough, bloody sputum, perifocal inflammation (Cr pneumonia), chest  pain, hyperthermia, general weakness, pain in extremities and joints. Also with progressive processes: superior vena cava syndrome, decreased tone of voice, respiratory failure. After identification of the initial clinical symptoms of lung cancer, it is advisable to have a chest X-ray, chest CT scan, bronchoscopy, transthoracic biopsy (if necessary), and ultrasound.

Thymoma

Thymoma is attributed to a  group of mediastinal neoplasms that develop from the epithelial cells of the thymus gland. The clinical presentation of thymoma can be varied: asymptomatic; with marked symptoms (compression, pain, myasthenia, intoxication syndrome). Diagnosis based on topography and etiology is established by X-ray examination, mediastinoscopy and biopsy.

Surgical treatment for thymomas includes thymectomy, anterior mediastinal lymphodissection, and chemoradiotherapy if necessary.

Thymoma is an organ-specific tumor of the mediastinum, which develops from the cellular elements of the medullary and cortical tissue of the thymus gland. The causes of tumors of the thymus gland are unknown; it has been suggested that thymoma may be of embryonic origin and associated with impaired thymopoietin and immune homeostasis synthesis.

Risk factors for thymoma may include: infectious diseases, radiation exposure, trauma to the mediastinum (chest). Thymomas are often associated with a number of endocrine and autoimmune syndromes (myasthenia, dermatomyositis, systemic lupus erythematosus, diffuse toxic gout, Itsenko-Cushing syndrome).

Symptoms

The clinical presentation of a thymoma depends on its type, hormonal activity and size. In most cases, thymomas are characterized by a latent course and are detected by physical examination. Invasive thymomas cause compression mediastinal syndrome characterized by: chest pain, dry cough, shortness of breath. Compression of the trachea and large bronchi is manifested by: stridor, cyanosis, respiratory failure. If the superior vena cava is compressed, swelling of the face, livid coloring of the upper third of the body and swelling of blood vessels in the neck region develop. If the nerve tissue is compressed, Horner’s syndrome, lowered tone of voice, high position of the diaphragmatic cupula occur..

If the esophagus is compressed, dysphagia (difficulty swallowing) develops. Myasthenic syndrome is reported in 10-40% of cases. Patients report marked general weakness, muscle weakness, easy fatiguability, easy fatiguability of mimic muscles, double vision, regurgitation and a lowered  tone of voice. In severe cases a myasthenic crisis may develop, requiring the patient to be transferred to controlled breathing and tube feeding.

In advanced malignant thymoma there is a clinical picture of tumor intoxication, fever, anorexia and weight loss. Not infrequently, thymoma is accompanied by various hematological and immunodeficiency syndromes: aplastic anemia, thrombocytopenic purpura, hypogammaglobulinemia.

Diagnosis

Thymoma is diagnosed using radiological methods: chest X-ray, chest CT scan, mediastinoscopy, tumor biopsy and histomorphological biopsy, electromyography. Differential diagnostic measures allow to exclude (or confirm) the presence of a mass forming  processes in the mediastinum: goiter with retrosternal spread, dermoid cyst, mediastinal teratoma.

If you notice the above symptoms, it is better to see your doctor in good time.

The Thoracic (Chest) Department at the Mardaleishvili Medical Center includes nosologies such as: malignant diseases of the lungs and mediastinal organs. The treatment of malignant tumors of the above-mentioned organs is carried out in our clinic with modern methods. At Mardaleishvili Medical Center’s Thoracic (cardio-thoracic) Surgery Department the high-technological  surgeries are performed by our experienced oncologist Levan Bakhtadze who has been working in leading oncology research clinics abroad for 10 years. Patients are treated individually at our clinic. All patients are examined by a board of specialists: oncologists, chemotherapists, radiologists, therapists, anesthetists and resuscitators.

In addition, diagnostic and therapeutic manipulations (biopsy of cancerous or solid tumors of lungs, mediastinum and abdomen with CT or echo-control), biopsy of tumor formations of soft tissues with CT or ultrasound control for the diagnosis are carried out at the Mardaleishvili Medical Center.

In our clinic, patients are treated according to European standards.