Objective To investigate the effects of gefitinib in the treatment of sarcomatoid carcinoma. Methods Clinical data of a case of sarcomatoid carcinoma was analyzed and related literatures were reviewed.Results A patient with sarcomatoid carcinoma was admitted with progressive dry cough,chest pain and dyspnea for 3 months. The patient was diagnosed as lung sarcomatoid carcinoma by thoracoscopy and treated with gefitinib. After 2 weeks treatment, symptoms disappeared and tumor was stable for 4 months. Literatures review suggested that sarcomatoid carcinoma is a rare malignant tumor. Treatment of sarcomatoid carcinoma includes surgery, chemotherapy and radiotherapy, but these methods show little effect in advanced patients. In our case, the patient with sarcomatoid carcinoma in stage Ⅳ was treated by gefitinib and showed favourable effect. Conclusions Advanced sarcomatoid carcinoma patients have a short life span and poor life quality. Gefitinib may provide these patients a feasible therapeutic approach.
Objective To observe an early result after the repair of the large upper thoracic wall defect by a combined use of the titaniumnet, reconstruction nickelclad, and latissimus dorsi myocutaneous flap in a patient who underwent a breast sarcomatoid caricinoma resection on the upper thoracic wall. Methods A breast sarcomatoid carcinoma in the upper thoracic wall was removed in 1 56yearold female patient in February 2006. After the tumorectomy, a large thoracic wall defect was left, which was 20cm×15cm in size. The defect was covered by the titanium net, the bilateral stumps of the clavicles were connected by the reconstruction nickelclad, and the soft tissue defect was repaired with the right latissimus dorsi myocutaneous flap(20cm×15cm). Results The patient depended on the breathing machine for 3 days after operation. When the breathing machine was discontinued, the patient developed a severe paradoxical breathing. Two weeks after operation when theblood circulation of the flap was stabilized, the paradoxical breathing disappeared with the help of the chest bandage for fixation of the chest cavity, and the blood supply of the flap was improved. The chest X-ray film showed that the titanium net and the reconstruction nickelclad were well positioned. The patient received chemotherapy 1 month after operation, The follow-up for 3 months revealed that the patient’s local condition and physical condition were good, and ROMof both the shoulders was improved, with AF 90° and ABD 90°. No recurrence ofthe tumor was found. Conclusion A large thoracic wall defect should be repaired with solid materials. The normal anatomic locations of the clavicles should be maintained with fixation by the reconstruction nickelclad for a good function of the shoulders. The latissimus dorsi myocutaneous flap can be properly enlarged.