A neuroendocrine tumor within an anterior mediastinal mature teratoma: a case report.

BACKGROUND: Mature teratomas are benign germ cell tumors. On rare occasions, they have been associated with somatic malignancies and are termed rare germ cell tumors with a somatic-type malignancy (GCTSM). Mature teratomas commonly comprise adenocarcinomas; only seven previous cases of mature teratomas with neuroendocrine tumors have been reported to date. Here, we report a patient with a neuroendocrine tumor whithin a mature teratoma. CASE PRESENTATION: A 26-year-old man visited our department complaining of chest tightness. Contrast-enhanced computed tomography (CT) scans showed a strongly enhanced lesion within a 10-cm encapsulated cystic lesion in the anterior mediastinum. Positron emission tomography (PET) scans showed no areas of significant 18F-fluorodeoxyglucose (18F-FDG) accumulation. He underwent complete tumor resection via the transsternal approach. Histopathological examination of the specimen indicated a neuroendocrine tumor contained within a mature teratoma. CONCLUSIONS: In this case, a neuroendocrine tumor was contained within a mature teratoma. Our patient had no specific symptoms and his serum markers were within the normal range. Although PET is beneficial for diagnosing other GCTSM, it is not useful in detecting a neuroendocrine tumor. Therefore, the preoperative diagnosis of neuroendocrine tumors contained within mature teratomas remains challenging. However, GCTSM should be suspected in patients exhibiting CT findings of a mediastinal tumor, measuring ≥ 6 cm, in addition to characteristic GCTSM findings. Moreover, surgery should be performed carefully in such cases.

Intrapericardial Ectopic Goiter: A Very Unusual Presentation.

Mediastinal ectopic goiter is a thyroid tumor that lies entirely below a plane extending from the superior surface of the first thoracic vertebra to the suprasternal notch, and commonly lies in the vicinity of the thymus. Intrapericardial ectopic goiter is extremely rare. We present an extremely rare case of a 63-year-old woman with an intrapericardial ectopic goiter and review the pertinent literature.

[Contralateral Pneumothorax after Surgery for Idiopathic Hemopneumothorax;Report of a Case].

A 17-year-old man came to the hospital complaining of right back pain. He had a history of an emergency operation for a left idiopathic hemopneumothorax. A chest X-ray revealed right lung collapse and suggested pleural adhesion at the apex of the right lung. He was diagnosed with right spontaneous pneumothorax and the surgical treatment was performed, because pleural adhesion may cause the hemothorax. During surgery, several pleural adhesion bands were found in the thoracic cavity between the right lung apex and chest wall. Spontaneous pneumothorax with a pleural adhesion at the apex is considered to be the indication for surgery because of the risk of hemothorax.

[Birt-Hogg-Dubé Syndrome Diagnosed with Surgery;Report of Three Cases].

Birt-Hogg-Dubé (BHD) syndrome is an autosomal and predominantly inherited disorder. We report 3 cases of BHD syndrome. Case 1:A 24-year-old man was admitted to our hospital due to left-sided spontaneous pneumothorax. He had a previous drainage history of right-sided spontaneous pneumothorax. In operation, we resected the cyst at segment 8 of the left lung and covered the lung using polyglycolic acid( PGA) sheet. Case 2:A 47-year-old man was admitted to our hospital due to right-sided spontaneous pneumothorax. He had a previous surgical history of right-sided spontaneous pneumothorax and left-sided spontaneous pneumothorax. In operation, we resected the cyst at segment 8 of the right lung and covered the lung using fibrin glue-coated collagen fleece. Case 3:A 60-year-old man was admitted to our hospital due to left-sided spontaneous pneumothorax. He had 2 times of previous drainage history of left-sided spontaneous pneumothorax. In operation, we resected the cysts at lingular division of the lung and covered the lung using PGA sheet. On genetic analysis, all 3 cases were diagnosed with the BHD syndrome.