Situation
How do you manage the
following situations?
1 Previous
radiotherapy and now needs resection
2 Previous breast
cancer and pulmonary mass
1 Previous
radiotherapy and now needs resection
If radiotherapy on
same side as proposed resection there is an increased risk of would infections
due to the endarteritis obliterans, but assessment of pulmonary function is
relatively straightforward. However if the radiotherapy is to the contralateral
side then PFTs are difficult to interpret as radiotherapy damages the underlying
lung, which you are leaving in. Quantitative VQ scanning and diffusion
coefficient assessment may help.
2 Previous breast
cancer and pulmonary mass
Breast cancer is a
micro metastatic disease so a bone scan in the absence of bone pain should be
done.
3 Difference on CT
between mesothelioma and empyema
Mediastinal pleural
thickening is said to be more likely mesothelioma than empyema. Calcified
pleural plaques can occur in both.