Understanding the uncommon thoracic tumors.

252 Cancer Control Dr Robinson focuses on a solitary fibrous tumor of the pleura, the less aggressive form of pleural tumors. Its unique radiologic characteristic and clinical course are concisely presented. The third article is dedicated to large-cell neuroendocrine carcinoma, the less common form of NSCLC. Drs Fernandez and Battafarano review the classification of pulmonary neuroendocrine tumors, the prognosis of large-cell neuroendocrine carcinoma, and the implication for its management. In the fourth article, Dr Taveira-Dasilva and colleagues provide a comprehensive review of lymphangioleiomyomatosis (LAM), a tumor of smooth, muscle-like cell originating within the lung tissue. Its perplexing pulmonary cyst formation and extrapulmonary manifestation are vividly illustrated along with promising ongoing research. The last article in this series of uncommon thoracic tumors covers tracheobronchial tumors, including mucinous cystadenoma, pleomorphic adenoma, mucoepidermoid carcinoma, and adenoid cystic carcinoma. Drs Gaissert and Mark describe the unique features of these tumors and the success with segmental tracheal or bronchial resection. While these articles cover most of the less common thoracic tumors, other infrequent but important thoracic tumors include carcinoid tumor, thymic tumor and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH). The pulmonary carcinoids, both typical and atypical, are part of the spectrum of pulmonary neuroendocrine tumors; both have a better prognosis than SCLC and large-cell neuroendocrine tumor. Surgery is the cornerstone of treatment, and somatostatin receptor scintigraphy, though generally useful in gastroenteropancreatic carcinoids, can also be helpful for staging. For thymic tumors, many studies have now shown that unresectable disease may be cured by treatment with induction chemotherapy followed by radiation,while Thoracic tumors continue to account for the highest number of cancer deaths in the United States. Non-small cell lung cancer (NSCLC) is the most common, followed by small-cell lung cancer (SCLC). This year, the American Cancer Society estimates that about 175,000 new cases of thoracic tumors will be diagnosed and 160,000 people will die of tumors of lung and bronchus.1 In addition to these common thoracic tumors, several less common tumors arise from other thoracic cavity structures, including pleura, airway, mediastinum, and chest wall. The lung tissue itself can also harbor less common forms of tumors such as carcinoid and large-cell neuroendocrine carcinoma. A rough estimate indicates that this heterogenous cluster of uncommon thoracic tumors may constitute up to 5% of all thoracic tumors (Table). This in itself makes the word “uncommon” indeed debatable. In this issue of Cancer Control,we explore the road less traveled: five selected uncommon thoracic tumors are reviewed by multidisciplinary experts in their particular field. The first article, by Dr Ismail-Khan and colleagues, provides an up-to-date summary of malignant pleural mesothelioma. Current state-of-the-art treatment is comprehensively reviewed, including selection criteria for extrapleural pneumonectomy and promising agents still under investigation. In the second article, Understanding the Uncommon Thoracic Tumors Editorial Cancer Control Journal of the Moffitt Cancer Center