Objective To assess the safety,effectiveness,indications and advantage of modified "Hemi-Clamshell" approach for giant anterior mediastinal tumor.Methods From Apr 2003 to May 2012,24 patients (18 males and 6 females,median aged 40 years old) with giant anterior mediastinal tumor (average dimension:11.3 cm × 9.3 cm) were treated through modified "Hemi-Clamshell" approach.In operation,anterolateral thoracotomy with sternum transection was performed through 3rd or 4th intercostal space from midclavicular line to contralateral parasternal line.Then a radical or palliative resection of the tumor was performed.Results There were no mortality and major morbidity peri-operatively.A myasthenic crisis occurred for a patient with thymoma and myasthenia gravis.16 operations were performed through 3rd intercostal space and 8 through 4th.15 cases of tumor were radically resectedaverage dimension of tumors was 11.2 cm × 9.1 cm while the other 9 were palliativly resectedthe average dimension of tumors was 11.3 cm × 9.5 cm.Because of the extranodal invasion of the tumor,14 patients received extended operations.All the patients were followed-up to Aug 2013,the overall period of follow-up were 6-124 months.The survival postoperative for the patients of radical resection group were 11-124 months and for the palliative resection group were 6-66 months.Conclusion Manufacture of the modified "Hemi-Clamshell" approach is fast and convenient,and the exploration of the mediastinal organs is satisfied.This modified approach can be used for great majority of the mediastinal tumors.This approach is suitable for promotion at the primary hospitals and the prospect of application is well.

Pulmonary glomus tumors are extremely rare, with only 19 cases having been reported worldwide. The glomus body is considered to be related to the regulation of body temperature, but the reported cases were not associated with hyperpyrexia. Here, we describe a 28-year-old man with hyperpyrexia and anemia complicated with a coin lesion of the right lung. After resection of the upper lobe of the right lung by video-assisted thoracoscopic surgery, all of the patient's symptoms disappeared. The pathologic analysis reported a rare pulmonary glomus tumor. The disease had not recurred by 1 year after operation. (Ann Thorac Surg 2013;95:e29-31) (c) 2013 by The Society of Thoracic Surgeons