Development of Castleman Disease in the Paravertebral Space Mimicking a Neurogenic Tumor / 대한흉부외과학회지

Castleman disease is a relatively rare disease, characterized by well-circumscribed benign lymph-node hyperplasia. The disease may develop anywhere in the lymphatic system, but is most commonly reported as unicentric Castleman disease in the mediastinum along the tracheobronchial tree. It is usually asymptomatic and detected on plain chest radiography as an incidental finding. We report an incidentally detected case of Castleman disease in the paravertebral space that was preoperatively diagnosed as a neurogenic tumor and treated by complete surgical resection.

Anterior mediastinal synovial sarcoma: A case report and literature review / 解放军医学杂志

Objective To study the clinical manifestations, pathologic features, diagnosis, treatment and prognosis of primary synovial sarcoma in the anterior mediastinum. Methods A case of primary synovial sarcoma in the anterior mediastinum was reported. Clinical features, imaging manifestations, pathology features and therapeutic effect were analysed and the relevant literature was reviewed. Results A 48-year-male patient was admitted with complaint of right chest pain for 4 days. Chest computerized tomography revealed a large mass located at the right anterior mediastinum, and it was primarily diagnosed as invasive thymoma. Pathological examination by CT-guided percutaneous needle biopsy manifested that, under microscope, the tumor cells were short and spindle in shape forming a nest structure, suggested it was a thymoma. The patient then underwent resection of thymoma with removal of fat and connective tissue in the anterior mediastinum. During the operation the size of the tumor was 15cm × 15cm × 10cm, being located at the anterior mediastinum, and it tended to bleed. The diagnosis of primary monophasic synovial sarcoma in the mediastinum was confirmed by postoperative/pathology examination. Immunohistochemistry staining showed that the tumor cells were positive for the markers Bcl-2 and EMA, but negative for the markers CK (pan) and S100. The patient suffered from local recurrence with metastases to lung 4 months after surgery. The patient received 2 chemotherapeutic courses with ifosfamide, epirubicin and cisplatin. He died 6 months after surgery. Conclusion Primary synovial sarcoma in the anterior mediastinum is an extremely rare and highly malignant tumor with poor prognosis. The diagnosis depends on the pathological features, immunohistochemistry and RT-PCR. Radical resection combined with comprehensive treatment may improve the survival rate.

Carcinoma tímico metastático com resposta prolongada a pemetrexed e octreotide / Metastatic thymic carcinoma with prolonged response to pemetrexed and octreotide

Em adultos os carcinomas tímicos representam cerca de 20% das neoplasias mediastinais. A maioria dos pacientes tem entre 40 e 60 anos de idade e há ligeira predominância do sexo masculino. Em função da raridade da doença não há ensaios clínicos randomizados realizados para orientar a escolha do tratamento na doença metastática refratária ou recorrente. Alguns regimes de segunda linha têm sido usados, a maioria baseada em cisplatina. Como linhas alternativas as opções são pemetrexed, 5-flourouracil associado a leucovorin, gemcitabina, capecitabina e paclitaxel, todas com taxas de resposta pequenas. Relatamos neste artigo um caso de carcinoma tímico tratado com pemetrexed e octreotide com resposta prolongada ao tratamento.

Tumor raro em mediastino: hamartoma / A rare mediastinum tumor: hamartoma

In the present paper we report a case of mediastinal tumor which we believe has never been reported. Since surgical treatment, the patient presented good evolution. We discuss the presentation, differential diagnosis and therapy. Finally, we stress the importance of the pathologic findings.

Inflammatory Pseudotumor in the Mediastinum: Imaging with 18F-Fluorodeoxyglucose PET/CT

Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.

Primary Malignant Melanoma of the Mediastinum: Radiologic and Pathologic Correlation in Two Case

Primary malignant melanoma of the anterior mediastinum is extremely rare, accounting for 0.1-0.5% of all primary malignant neoplasms. These tumors may be mistakenly diagnosed as lymphomas, thymic carcinomas and malignant germ-cell tumors of the mediastinum. We describe two cases of primary malignant melanomas of the anterior mediastinum and report their CT and pathology findings.

Massa torácica sintomática em adulto jovem: teratoma gigante do mediastino: relato de caso / Symptomatic thoracic mass in young adult: giant mediastinal teratoma: case report

JUSTIFICATIVA E OBJETIVOS: A maioria dos tumores mediastinais é assintomática e, portanto, são descobertos incidentalmente através de achados radiológicos. O objetivo deste estudo foi relatar um caso clínico desse tipo de tumor e discutir a classificação, diagnóstico diferencial e prognóstico da rara apresentação dessa doença. RELATO DO CASO: Paciente do sexo masculino, 26 anos, imunocompetente, apresentou sinais e sintomas de síndrome da veia cava superior associado com sudorese noturna e perda de peso significativa, tendo como causa mais provável algum tipo de tumor mediastinal. CONCLUSÃO: Apesar de ser uma doença rara, deve-se ter em mente que os tumores mediastinais acometem com mais frequência os jovens. Portanto o prognóstico depende do diagnóstico precoce, tipo histológico e a forma de tratamento empregada.

BACKGROUND AND OBJECTIVES: The majority of mediastinal tumors is asymptomatic and therefore is discovered incidentally by radiological findings. The aim of this study was to report a case ofthis type of tumor and discuss the classification, differential diagnosisand prognosis of a rare presentation. CASE REPORT: Male patient, 26 years old, immunocompetent, had signs and symptoms of superior vena cava syndrome associated with night sweats and weight loss as having significantly more likely cause some type of mediastinal tumor. CONCLUSION: Although a rare disease, one should bear in mind that the mediastinal tumors most commonly affect young people. Sothe prognosis depends on early diagnosis, histological type and form of treatment used.

Calcifying Fibrous Pseudotumor of the Anterior Mediastinum

Calcifying fibrous pseudotumors are rare soft-tissue lesions pathologically characterized by hyalinized collagen, psammomatous or dystrophic calcification, and lympho-plasmacyte infiltration. They are clinically benign with an extremely low rate of recurrence and complete surgical resection is known to be the treatment of choice. We performed the resection of a calcifying fibrous pseudotumors in the anterior mediastinum without complications.

Calcifying Fibrous Pseudotumor of the Anterior Mediastinum

Calcifying fibrous pseudotumors are rare soft-tissue lesions pathologically characterized by hyalinized collagen, psammomatous or dystrophic calcification, and lympho-plasmacyte infiltration. They are clinically benign with an extremely low rate of recurrence and complete surgical resection is known to be the treatment of choice. We performed the resection of a calcifying fibrous pseudotumors in the anterior mediastinum without complications.

Venous Hemangioma Mimicking Mediastinal Solid Mass: A case report / 대한흉부외과학회지

An occurrence of hemangioma in the mediastinum is a very rare, accounting for less than 0.5% of mediastinal tumors. Capillary hemangiomas and cavernous hemangiomas consists of over 90% of mediastinal hemangiomas. However, venous hemangioma has never been reported in South Korea and has also very rarely been reported worldwide. We found mediastinal solid mass, as an incidental finding during a follow-up chest CT scan of a 44-year-old female patient who had undergone colon cancer surgery. We performed a mediastinoscopic biopsy. We did a thoracotomy to remove this mass because hemorrhage and found a totally resected venous hemangioma.

Thymolipoma in a 13-year-old Korean girl / 소아과

Thymolipoma is a rare benign tumor of anterior mediastinum. Most patients are asymptomatic with incidental finding of the tumor during a diagnostic workup of other medical problems. We present a case of 13-year-old girl with anterior mediastinal thymolipoma, surgically removed after an incidental diagnosis.

Occult Papillary Thyroid Carcinoma Presenting as a Huge Mediastinal Cystic Metastasis / 대한흉부외과학회지

The initial presentation of distant metastases in patients with papillary thyroid carcinoma is quite rare. Most distant metastases are solid nodular lesions. A 67-year-old man who complained of severe dyspnea underwent surgery due to a large mediastinal cystic mass compressing the trachea and great vessels. Pathologically, the cystic mass was a metastatic thyroid papillary carcinoma. The thyroid evaluations were compatible with a well differentiated thyroid carcinoma. An occult thyroid carcinoma presenting as a large mediastinal cystic lesion is extremely rare.

Squamous Cell Carcinoma Arising in a Thymic Cyst : A Brief Case Report

We present here the case of a 73-year-old man with squamous cell carcinoma that arose in a thymic cyst, and this was incidentally found by chest radiography. Computed tomography revealed a 3.6 cm-sized predominantly cystic lesion with a mural nodule at the antero-superior mediastinum. The resected specimen was a well demarcated cystic mass with a solid mural nodule. Microscopically, the nodule was determined to be invasive squamous cell carcinoma that had originated from the benign squamous epithelium lining the thymic cyst.

Lipoblastoma of Mediastinum: A case report / 대한흉부외과학회지

Lipoblastoma is a rare benign tumor that usually originates in children from the embryonic lipid cells of the extremities. This condition shows an early childhood occurrence, a benign nature without metastasis, a cellular composition of mainly mature lipid cells and an ability to differentiate into a simple lipoma. We have experienced a 15 month old girl who had developed a lipoblastoma in the right anterior mediastinum. Surgical resection was carried out without complications. Her postoperative course was uneventful. She has been well 6 months after the operation.

Mature Cystic Teratoma / 대한내과학회지

No abstract available.

First Experience of Thoracic Surgery with the da Vinci(TM) Surgical System in Korea / 대한흉부외과학회지

Video-assisted thoracoscopic surgery has gained a broad acceptance for various thoracic lesions because it is the minimally invasive surgery with little tissue trauma, less pain, improved cosmetic results and short recovery time. However, there are some limitations for this method, such as restricted visual sensory information to a two-dimensional image and limited maneuverability of the tips of the instruments. To overcome these limitations, advanced technology has been introduced and the da Vinci(TM) Surgical System (Intuitive Surgical Inc, Mountain View, CA, USA) became available in 2001. In Korea, the da Vinci(TM) Surgical System was introduced in Severance hospital (Yonsei University College of Medicine) in May 2005, and approved by KFDA in July 2005. Herein, we report the first experience of robot-assisted thoracic surgery with the da Vinci(TM) Surgical System in extirpation of a large teratoma in anterior mediastinum.

A Case of Extramedullary Plasmacytoma Arising from the Posterior Mediastinum

Plasmacytomas are a localized proliferation of plasma cells in the bone marrow, and are less frequently seen in extraosseous organs or tissues. Extramedullary plasmacytoma is a rare malignant neoplasm, and is especially uncommon when it arises from the mediastinum. Here, we report on a case of posterior mediastinal extramedullary plasmacytoma in a 64-year-old man. He was admitted with an asymptomatic right apical mediastinal mass, which was provisionally diagnosed as a neurogenic mass. However, a subsequent investigation revealed that this tumor was a rare case of IgG kappa type extramedullary plasmacytoma arising from the posterior mediastinum. The patient was treated with local radiation to the mediastinum and is doing well without further evidence of disease.

Extrapleural Pneumonectomy for the Anterior Mediastinal Liposarcoma with Invasion of Pleura and Lung: 1 case report / 대한흉부외과학회지

Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for liposarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondrosarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.

Cervico-Mediastinal Lipoma with Horner's Syndrome: A case report / 대한흉부외과학회지

Lipoma is a circumscribed mesenchymal tumor originating from the adipose tissue. The lesion is usually small and asymptomatic. The most common location is in the neck region, however, lipoma can be found in the mediastinum in rare occasions. Although lipoma reach to the large proportions in the mediastinum, it rarely compresses the neurovascular structure. We present a case of a 58-year-old man, in which a hourglass-type cervicomediastinal lipoma produced Horner's syndrome with voice change. The man presented a swelling at the right side of his neck, ptosis and anhidrosis on the right side of his face, and right chest discomfort. After the removal of the mass, all the symptoms which had been provoked by compression, as well as Horner's syndrome and hoarseness, nearly disappeared.

Video-assisted Thoracoscopic Excision of Mediastinal Masses / 대한흉부외과학회지

BACKGROUND: Due to its less invasive nature and superior visual field, video-assisted thoracoscopic excision of mediastinal mass is thought to be comparable to open thoracotomy. MATERIAL AND METHOD: From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy. RESULT: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2 +/-35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6+/-7.0 minutes, mean postoperative tube stay was 4.2+/-0.4 days, mean postoperative hospital stay was 5.2+/-0.4 days, and mean number of injection of analgesics was 1.9+/-0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of video- assisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. CONCLUSION: As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.