Tumores de mediastino anterior: nuestra experiencia en el Hospital Base de Linares / Anterior Mediastinal Tumours: our experience in the Hospital Base of Linares

INTRODUCCIÓN: Los tumores de mediastino constituyen una entidad clínica poco frecuente, generalmente asintomática. Se pueden desarrollar desde estructuras que se ubican en el compartimento anterior, medio y posterior, siendo la primera, la ubicación más usual. En los adultos, timomas y linfomas (Hodgkin y no Hodgkin) son las masas más comunes del mediastino anterior, junto al bocio endotorácico y los teratomas; todas en su conjunto son conocidas como las "4 T del Mediastino Anterior". Casos clínicos: Se exponen tres casos clínicos de tumores de mediastino anterior, intervenidos en nuestro centro. Discusión: Las masas mediastínicas constituyen una entidad clínica infrecuente. La tomografía computada de tórax con y sin contraste intravenoso es utilizada para evaluar estas anormalidades descubiertas radiográficamente. El diagnóstico definitivo generalmente requiere una muestra de tejido que se obtiene mediante biopsia antes del tratamiento o como parte de una resección terapéutica planificada de toda la masa. En Chile, existen pocos trabajos recientes que muestren las características clínicas de pacientes que presentan timomas o linfomas; es por esto que se hace importante la presentación de estos casos que constituyen un aporte al conocimiento nacional.

INTRODUCTION: Mediastinal tumours constitute a clinical entity infrequent, generally asymptomatic. It can develop from structures localized on anterior compartment, middle and posterior, where structure localized on anterior compartment is usual. Adults tend to have thymomas and lymphomas more common in anterior mediastinal within intrathoracic goiter and teratomas. They are known as a "4T of anterior mediastinal mass". Clinical cases: Three clinical cases of anterior mediastinal tumours are exposed in our centre. Discussion: Mediastinal mass constitutes a clinical entity infrequent. The computed Tomography of the thorax with intravenous contrast and without intravenous contrast are used to evaluate abnormalities discover by radiography. The final diagnosis requires a fabric sample which is obtained by a biopsy before the treatment or as a part of a planned therapeutic recession. In Chile exist a few recently studies that shows clinical characteristics of patients which presents thymus and lymphomas as a result is important to present this kind of cases due to these cases constitute to the national knowledge.

Carcinoma tímico: causa de alargamento mediastinal / Thymic carcinoma: cause of mediastinal enlargement

RESUMO: Relatamos o caso de um paciente do sexo feminino, 76 anos, com tosse há seis meses. Os exames laboratoriais estavam normais. Na radiografia do tórax observou-se alargamento do mediastino no terço médio do tórax. Posteriormente, foram realizadas tomografia computadorizada e ressonância magnética do tórax que caracterizaram uma massa localizada no mediastino anterior, envolvendo a aorta ascendente e comprimindo a veia cava superior. O diagnóstico histológico pós-biópsia e ressecção parcial da lesão foi de um carcinoma tímico de células escamosas. (AU)

ABSTRACT: We report the case of a female patient, 76 years old, with a cough for six months. Laboratory tests were normal. Chest X-ray revealed enlargement of the mediastinum in the middle third of the thorax. Later, computed tomography and magnetic resonance imaging of the thorax were performed, characterizing a mass located in the anterior mediastinum, involving the ascending aorta and compressing the superior vena cava. Histological diagnosis after biopsy and partial resection of the lesion was a thymic squamous cell carcinoma. (AU)

Síndrome de Klinefelter diagnosticado en un adulto a raíz del estudio de infección respiratoria recurrente y masa mediastínica: caso clínico / Thymoma in a patient with klinefelter syndrome: case report

Klinefelter syndrome (47, XXY in most cases) is a frequently underdiagnosed chromosomal anomaly associated with multiple comorbidities in adult life. Patients with Klinefelter syndrome have a higher risk of cancer. Specifically, these patients have a higher risk for mediastinal germ cell tumors. It is estimated that 8% of male patients with mediastinal tumors have Klinefelter. We report a 42-years-old male who suffered recurrent respiratory infections. During the study, a mediastinal mass was found, whose pathological study disclosed a type B thymoma. The patient had a history of infertility, high stature, gynecomastia, obesity with gynecoid distribution of body fat and testicular atrophy. A karyotype was requested (47, XXY), confirming the diagnosis of Klinefelter syndrome.

Thymoma Associated with Myasthenia Gravis in Infancy.

Thymomas are associated with various autoimmune disorders in adults, most commonly with myasthenia gravis (MG). In MG antibodies developed against acetylcholine (ACh) receptors, resulting weakness of muscle after repeated use and recovery following a period of rest. However, MG due to thymoma is extremely rare in pediatric age group.1We report an infant with MG due to invasive thymoma.