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Social media serves as a tool to fill gaps in current efforts to promote women in cardiothoracic surgery, and, given its global reach, may be a particularly effective modality. Social media has an important role in networking and mentorship, especially for women seeking careers in specialties with relatively sparse female representation, such as cardiothoracic surgery. In addition, social media may facilitate professional interactions, collaboration, growth of online reputations, engagement in continued education, communication of novel research findings, and patient education. Herein, we review the evidence for social media in the networking and mentorship of women in cardiothoracic surgery. Future studies are needed to establish the durability of social media efforts and predictors in its effectiveness in achieving its goals., Competing Interests: Conflicts of Interest: The authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.04.11). The series “Women in Thoracic Surgery” was commissioned by the editorial office without any funding or sponsorship. MA serves as an unpaid editorial board member of Journal of Thoracic Disease from Aug 2019 to Jul 2021. The authors have no other conflicts of interest to declare., (2021 Journal of Thoracic Disease. All rights reserved.)

Background: Multiple synchronous lung tumors (MSLT), particularly within a single lobe, represent a diagnostic and treatment challenge. While histologic assessment was once the only method to possibly distinguish multiple primary lung cancers, there is a growing interest in identifying unique genomic features or mutations to best characterize these processes., Methods: In order to differentiate multiple primary lung malignancies from intrapulmonary metastases in patients with MSLT, we performed whole exome sequencing (WES) on 10 tumor samples from 4 patients with MSLT., Results: Shared mutations between tumors from the same patient varied from 0-91%. Patient 3 shared no common mutations; however, in Patients 2 and 4, identical mutations were identified among all tumors from each patient, suggesting that the three tumors identified in Patient 3 represent separate primary lung cancers, while those of Patients 1, 2 and 4 signify hematogenous and lymphatic spread., Conclusions: A high proportion of shared mutations between different lung tumors is likely indicative of intrapulmonary metastatic disease, while tumors with distinct genomic profiles likely represent multiple primary malignancies driven by distinct molecular events. Application of genomic profiling in the clinical setting may prove to be important to precise management of patients with MSLT., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-1). CG has a patent named “Markers associated with ribavirin-induced anemia” that was issued in 2012. CB and IIW report grants and personal fees from Genentech/Roche, grants and personal fees from Bayer, grants and personal fees from Bristol-Myers Squibb, grants and personal fees from AstraZeneca/Medimmune, grants and personal fees from Pfizer, grants and personal fees from HTG Molecular, grants and personal fees from Merck, personal fees from GlaxoSmithKline, grants and personal fees from Guardant Health, personal fees from MSD, grants from Oncoplex, grants from DepArray, grants from Adaptive, grants from Adaptimmune, grants from EMD Serono, grants from Takeda, grants from Amgen, grants from Karus, grants from Johnson & Johnson, grants from Iovance, grants from 4D, grants from Novartis, grants from Oncocyte, grants from Akoya, outside the submitted work. JVH reports grants and other from AstraZeneca, other from Bristol-Myers Squibb, other from GlaxoSmithKline, other from Kairos Venture Investments, other from BrightPath Therapeutics, other from Hengrui Therapeutics, other from Eli Lilly, other from EMD Serono, grants and personal fees from Spectrum, other from Foundation One Medicine, grants from NIH/NCI, grants from American Cancer Society, grants from Checkmate Pharmaceuticals, outside the submitted work. Jianjun Z reports grants from Merck, grants from Johnson and Johnson, personal fees from BMS, personal fees from AZ, personal fees from GenePlus, personal fees from Innovent, outside the submitted work. MBA serves as an unpaid editorial board member of Journal of Thoracic Disease from Aug 2019 to Jul 2021. The other authors have no conflicts of interest to declare., (2020 Journal of Thoracic Disease. All rights reserved.)

A delayed diagnosis of tracheobronchial foreign body aspiration (FBA) may result in severe respiratory complications such as pneumonia, bronchiectasis, and atelectasis. Here, we present a rare case of a left lung destruction caused by a pen cap that remained in the left lower lobe bronchus for 25 years and was previously misdiagnosed as cavitary tuberculosis. The foreign body was not detected in bronchoscopic examination prior to surgery due to severe stenosis of the left main bronchus. The foreign body was found incidentally while the patient was undergoing left pneumonectomy. To the best of our knowledge, this the second longest delay to diagnosis of FBA reported. This case also exemplifies the grave consequences of misdiagnosis of FBA., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare., (2019 Annals of Translational Medicine. All rights reserved.)

Background: Thymic neuroendocrine tumors (NETs) are rare malignancies often treated in a multidisciplinary fashion. However, evidence for adjunctive therapy is limited, and predictors of survival and recurrence are not well established., Methods: Patients treated for thymic NETs at a single center from 1975 to 2018 were reviewed. Variables collected pertained to tumor factors, stage, and treatments, including surgery. Univariate and multivariate regression analyses were used to determine predictors of overall survival (OS) and recurrence., Results: We identified treated 49 patients, among whom 36 (73%) were male with a median age of 46 years. Surgical resection was pursued in 41 (84%) patients, and chemotherapy and radiation therapy were used in 27 (55%) and 21 (43%) instances as either neoadjuvant, adjuvant, or definitive therapy. Median tumor size was 6.5 centimeters and most tumors were intermediate-grade. During a median follow-up time of 60.8 months following surgical resection, disease recurrence was observed in 29 (71%) patients and median survival time was 83.7 months. In Kaplan-Meier analysis for survival, surgical resection was associated with a longer survival time (P=0.002), while receipt of neoadjuvant therapy was associated with poorer survival. Larger tumor size was associated with recurrence following resection (P=0.047)., Conclusions: Thymic NETs represent a heterogeneous disease with variable survival. While we are unable to report clear evidence that supports the use of adjunctive therapies, surgery is important to survival. Additionally, it is likely that those receiving induction chemotherapy represent a unique cohort with advanced or aggressive disease. Among surgical candidates, tumor size predicts disease recurrence., Competing Interests: Conflicts of Interest: This abstract was accepted for oral presentation at the Multidisciplinary Thoracic Cancers Symposium in San Diego, CA from March 14–16, 2019.