Lung transplantation for pulmonary metastases and radiation-induced pulmonary fibrosis after radioactive iodine ablation of extensive lung metastases from papillary thyroid carcinoma.

Endocrine Surgery Department, University of California, San Francisco, California, USA.
Thyroid (Impact Factor: 3.84). 05/2007; 17(4):367-9. DOI: 10.1089/thy.2006.0234
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    ABSTRACT: Recent advances have led to improved outcomes in lung transplantation. The International Society for Heart and Lung Transplantation Registry data have shown a steady increase in the number of cases performed annually. Although somewhat controversial, lung transplantation (LTx) for lung cancer has also slowly increased. The current role of LTx for malignant diseases and the management challenge of incidental lung cancer in the explanted lungs are reviewed herein. For a few particular scenarios (advanced multifocal bronchioloalveolar carcinoma causing chronic respiratory failure, end-stage lung disease concomitant with early stage lung cancer, and metastatic disease restricted to the lungs with the primary site controlled) in which nonsurgical alternatives fail to provide adequate palliation, LTx may be considered. Nevertheless, in order to achieve acceptable results, careful patient selection and staging are paramount. In patients with incidental bronchogenic carcinoma in the explanted lung following transplantation, the prognosis is mainly driven by the malignancy stage. LTx can be performed to treat malignant diseases with results approaching those for nonneoplastic indications, given that patients are carefully selected and staged. Although they have not been widely applied in the reported lung transplant literature, modalities such as endobronchial ultrasound and positron emission tomography scan are strongly encouraged and have the potential to further refine staging in this population.
    Current opinion in organ transplantation 08/2012; 17(5):479-84. DOI:10.1097/MOT.0b013e328357fff6 · 2.38 Impact Factor
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    ABSTRACT: In locally advanced thyroid cancer confined to the neck, lymph node surgery pursues curative intentions but is also performed for the prevention of complications. These complication may arise from the invasion of local structures, such as recurrent laryngeal nerve, compromising quality of life, or trachea and esophagus, which may be life-threatening [1]. The tumor biology of thyroid cancer is mainly determined by the respective tumor type (papillary, follicular, low-differentiated, undifferentiated, and medullary) and the extent of disease (intrathyroidal growth versus extrathyroidal extension; locoregional versus distant metastases). To complicate the matter further, clinical outcome is also influenced by a host of proliferative factors.
    12/2008: pages 173-193;
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    Chest 09/2010; 138(3):738-42. DOI:10.1378/chest.09-1961 · 7.13 Impact Factor