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Tuberkuloz Ve Toraks 2011Primary hyperparathyroidism is most commonly caused by either a parathyroid adenoma or parathyroid hyperplasia. Parathyroid adenomas also rarely attain huge proportions....
Primary hyperparathyroidism is most commonly caused by either a parathyroid adenoma or parathyroid hyperplasia. Parathyroid adenomas also rarely attain huge proportions. We present a case of a 63-year-old female patient causing hypercalcemia and the mass which is located in the mediastinum. High intact parathormone level secondary to an ectopic hypersecretory parathyroid adenoma were detected (642 pg/mL). It was removed via a right thoracic approach. In this case parathyroid adenoma measuring 7 x 5 x 4 cm and weighing 145 g; to our knowledge the greatest mass reported in the literature. Despite its huge size it did not cause many of the hypercalcemic symptoms.
Topics: Adenoma; Female; Humans; Hypercalcemia; Hyperparathyroidism; Mediastinum; Middle Aged; Parathyroid Neoplasms; Parathyroidectomy; Treatment Outcome
PubMed: 22087523
DOI: 10.5578/tt.2419 -
Journal of Cardiothoracic Surgery Jan 2023Cavernous hemangioma is a rare benign tumor which can sometimes mimic the clinical presentation and radiological findings of malignant tumors. Here we present a rare... (Review)
Review
BACKGROUND
Cavernous hemangioma is a rare benign tumor which can sometimes mimic the clinical presentation and radiological findings of malignant tumors. Here we present a rare presentation of cavernous hemangioma in the mediastinum (CHM), along with a literature review among the main databases.
CASE PRESENTATION
We present a 48-year-old male who had suffered from persistent cough as the sole symptom of an anterior CHM. Computed tomography scan demonstrated a 12.5 × 10.8 cm mass in the anterior mediastinum. The mass was surgically resected, and histopathological evaluation established the diagnosis of CHM. The patient was discharged in good condition, in which during his four-month follow-up period, no recurrence of the tumor has been observed.
CONCLUSION
Although cavernous hemangioma rarely present in the mediastinum, it should be considered in the differential diagnosis of mediastinal tumors. However, our review of literature demonstrated a female dominance and average age of 40 years, with a 52% mortality rate based on previous reports.
Topics: Male; Humans; Female; Adult; Middle Aged; Mediastinum; Mediastinal Neoplasms; Cough; Hemangioma; Hemangioma, Cavernous
PubMed: 36604701
DOI: 10.1186/s13019-023-02130-7 -
Cancer Cytopathology Nov 2023The objectives of this study were to investigate the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)/endoscopic ultrasound-guided...
BACKGROUND
The objectives of this study were to investigate the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)/endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of amyloidosis coupled with the feasibility of mass spectrometry (MS) for amyloid subtyping.
METHODS
All patients who had amyloid diagnosed by EBUS-TBNA/EUS-FNA at two tertiary care centers from 2011 to 2020 were retrieved along with the MS subtype, clinical findings, and outcomes.
RESULTS
Eight patients were included: seven underwent EBUS-TBNA of mediastinal lymph nodes, and one underwent EUS-FNA of a periportal lymph node. Ages ranged from 37 to 79 years (median, 69 years), with equal numbers of men and women. Presenting clinical history included one case each of follicular lymphoma, lymphoplasmacytic lymphoma, rheumatoid arthritis, possible sarcoid, cirrhosis, and chronic renal insufficiency, and one case each of suspected pulmonary and cardiac amyloidosis. All cases showed waxy, amorphous material on direct smears (n = 5) or ThinPrep slides (n = 3), which were confirmed as amyloid on Congo Red staining. Immunohistochemistry showed dominant lambda staining in two of three cases. MS was performed in all cases and identified five of the light-chain (AL) type, one of the heavy-chain/AL type, and two suggestive of AL amyloidosis. Bone marrow biopsy performed in seven patients demonstrated that three had monoclonal plasma cells and one had lymphoplasmacytic lymphoma. Two of four patients with systemic amyloidosis received chemotherapy and remained alive, whereas three with localized disease remained stable under observation.
CONCLUSIONS
EBUS-TBNA/EUS-FNA is effective for amyloidosis diagnosis and provides adequate material for ancillary tests, including MS, which can identify the precursor amyloidogenic protein, leading to appropriate patient management.
Topics: Male; Humans; Female; Adult; Middle Aged; Aged; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Tertiary Care Centers; Tertiary Healthcare; Bronchoscopy; Mediastinum; Lung Neoplasms; Lymph Nodes; Amyloidosis; Lymphoma; Neoplasm Staging
PubMed: 37641237
DOI: 10.1002/cncy.22751 -
Cellular and Molecular Biology... Feb 2022Germ cell tumor is the most common malignant tumor of the gonads, sometimes they are found in locations other than the gonads, called Extra-gonadal Germ cell tumours...
Germ cell tumor is the most common malignant tumor of the gonads, sometimes they are found in locations other than the gonads, called Extra-gonadal Germ cell tumours (EGCTs). Primary mediastinal germ cell tumors (PMGCTs) are a kind of rare neoplasm in the anterior mediastinum, including seminoma and non-seminomatous, or appear as a mixture. Primary mediastinal seminoma mixed with sarcoma is an extremely rare clinicopathologic entity. Previous studies have revealed that primary pure mediastinal seminomas are commonly sensitive to chemoradiotherapy and possibly to palliative excision. The treatment options for mixed germ cell tumor composed of seminoma and sarcoma remain unknown. Only one case of primary mediastinal seminoma with rhabdosarcoma has been reported in the literature up to date and the patient benefited from chemotherapy as the neoadjuvant therapy. However, cases of primary mediastinal seminoma with leiomyosarcoma have not been documented. Herein, we report a case of an 18-year-old patient, who presented with dyspnea, orthopnea, and chest pain, the CECT scan of the chest showed a large mass in the anterior mediastinum, which turned out to be seminoma mixed with leiomyosarcoma after partial excision. We investigate the treatment strategy and potential molecular mechanism of this disease. Finally, our study demonstrated that the patient benefited from the treatment of chemotherapy alone, or combined with target therapy after the operation. Meanwhile, the BRAF p.G466V, TP53 mutations, MTOR p.T1977I and exons 2-5 deletion of FLCN may be potential molecular mechanisms and oncogenic drivers of this disease.
Topics: Adolescent; Humans; Leiomyosarcoma; Male; Mediastinal Neoplasms; Mediastinum; Neoplasms, Germ Cell and Embryonal; Seminoma; Testicular Neoplasms
PubMed: 35818265
DOI: 10.14715/cmb/2021.67.5.14 -
Boletin Medico Del Hospital Infantil de... 2023Rhabdoid tumors are malignant neoplasms of low prevalence, aggressive behavior, and high mortality. They were initially described as renal tumors, although tumors with...
BACKGROUND
Rhabdoid tumors are malignant neoplasms of low prevalence, aggressive behavior, and high mortality. They were initially described as renal tumors, although tumors with the same histopathological and immunohistochemical characteristics have been discovered in other locations, mainly in the central nervous system. Few cases of mediastinal location have been reported internationally. This work aimed to describe the case of a mediastinal rhabdoid tumor.
CASE REPORT
We describe the case of an 8-month-old male patient admitted to the pediatric department with dysphonia and laryngeal stridor progressing to severe respiratory distress. Contrast-enhanced computed tomography of the thorax showed a large mass with homogeneous soft tissue density, and smooth and well-defined borders, with suspicion of malignant neoplasm. Due to the oncological emergency compressing the airway, empirical chemotherapy was initiated. Subsequently, the patient underwent incomplete tumor resection due to its invasive nature. The pathology report showed morphology compatible with a rhabdoid tumor, which immunohistochemical and genetic studies corroborated. Chemotherapy and radiotherapy to the mediastinum were administered. However, the patient died three months after the initial treatment due to the aggressive behavior of the tumor.
CONCLUSIONS
Rhabdoid tumors are aggressive and malignant entities difficult to control and have poor survival. Early diagnosis and aggressive treatment are required, although the 5-year survival does not exceed 40%. It is necessary to analyze and report more similar cases to establish specific treatment guidelines.
Topics: Child; Male; Humans; Infant; Mediastinum; Rhabdoid Tumor; Hospitalization
PubMed: 36867566
DOI: 10.24875/BMHIM.22000035 -
Seminars in Cardiothoracic and Vascular... Dec 2012The perioperative management of the patient with an anterior mediastinal mass (AMM) is viewed as one of the more challenging anesthetic endeavors. Diligent preoperative...
The perioperative management of the patient with an anterior mediastinal mass (AMM) is viewed as one of the more challenging anesthetic endeavors. Diligent preoperative planning is essential and often involves imaging studies using multiple modalities, pulmonary function assessment, and minimally invasive biopsy for tissue diagnosis prior to arriving in the operating room. Anesthetic induction, often without major risks in most patients, can be catastrophic in AMM patients, with possible complications that include complete airway obstruction and cardiovascular collapse. The authors present the case of a biopsy via anterior mediastinotomy under monitored anesthesia care (MAC)/sedation in a 39-year-old man, who presented with a large AMM causing significant right heart compression without tracheobronchial involvement. This procedure was followed by definitive mass resection approximately 6 weeks later. This review will explore the following: (1) the use of MAC/sedation for AMM biopsy, (2) methods of safely securing the airway in patients undergoing definitive mass resection via median sternotomy, (3) current opinions regarding the need for preoperative pulmonary function testing in these patients, (4) current opinions regarding the need for and timing of cardiopulmonary bypass in these cases, (5) the use of intraoperative transesophageal echocardiography during resection, and (6) the characteristics of mediastinal germ-cell tumors with sarcomatous conversion. Though multiple anesthetic methods have been proposed for the management of patients undergoing tissue biopsy and resection of an AMM, this case report presents 2 successful anesthetic options for 2 distinct surgical procedures. In every instance, the anesthetic management options must be tailored to the unique physiological needs of the patient presenting for surgery.
Topics: Adult; Anesthesia; Biopsy; Echocardiography, Transesophageal; Humans; Magnetic Resonance Imaging; Male; Mediastinal Neoplasms; Mediastinum; Neoplasms, Germ Cell and Embryonal
PubMed: 22891051
DOI: 10.1177/1089253212454336 -
Journal of Pediatric Surgery Nov 1989The diagnosis of radiolucent esophageal foreign bodies can be difficult, particularly in patients with predominant respiratory symptoms. The consequences of the...
The diagnosis of radiolucent esophageal foreign bodies can be difficult, particularly in patients with predominant respiratory symptoms. The consequences of the impaction of a foreign body in the esophagus are serious, and esophageal stenosis, perforation, acquired tracheoesophageal fistulas are among the complications already reported. An unusual complication of a nondiagnosed radiolucent plastic coin that remained impacted for 11 months on the posterior esophageal wall of a 20-month-old child, who presented only with respiratory symptoms, is reported. The foreign body eroded through the esophageal wall, causing an intramural abscess that was initially interpreted as a mediastinal mass, and the patient was operated on with the diagnosis of a foregut duplication. Literature on this situation was reviewed, and the problems associated with the diagnosis and treatment of children with radiolucent esophageal foreign bodies are discussed.
Topics: Abscess; Barium; Esophagus; Female; Foreign Bodies; Humans; Infant; Mediastinitis; Radiography
PubMed: 2809984
DOI: 10.1016/s0022-3468(89)80094-6 -
Lymphoblastic Lymphoma: Guidelines From the International Lymphoma Radiation Oncology Group (ILROG).International Journal of Radiation... Nov 2018Presentation with a large mediastinal mass is a hallmark of acute lymphoblastic lymphoma, a disease that is treated in the same way as acute lymphoblastic leukemia even... (Review)
Review
Presentation with a large mediastinal mass is a hallmark of acute lymphoblastic lymphoma, a disease that is treated in the same way as acute lymphoblastic leukemia even in the absence of marrow involvement. The role of mediastinal radiation for patients who achieve complete remission after chemotherapy has been overlooked and controversial. This document presents current knowledge on the role of radiation for lymphoblastic lymphoma and best practices for addressing how to deliver mediastinal radiation with modern technology.
Topics: Combined Modality Therapy; Computer Simulation; Humans; International Cooperation; Mediastinum; Motion; Practice Guidelines as Topic; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Radiation Oncology; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Intensity-Modulated; Remission Induction; Societies, Medical; Tomography, X-Ray Computed
PubMed: 30238900
DOI: 10.1016/j.ijrobp.2018.05.078 -
Cirugia Espanola Mar 2018
Topics: Adult; Esophageal Neoplasms; Humans; Leiomyomatosis; Male; Mediastinum
PubMed: 29033067
DOI: 10.1016/j.ciresp.2017.07.003 -
Journal of Equine Veterinary Science Jun 2019A 30-year-old Standardbred gelding was referred for chronic pleural effusion. Thoracic ultrasound revealed marked bilateral pleural effusion and a large heterogeneous...
A 30-year-old Standardbred gelding was referred for chronic pleural effusion. Thoracic ultrasound revealed marked bilateral pleural effusion and a large heterogeneous mass within the cranial mediastinum, which extended from the right 5th to the 11th intercostal space. Subsequently, on thoracic radiographs, the cranial mediastinal mass was confirmed, and a nodular interstitial pattern was identified in the lungs. Because of progressive clinical deterioration of the patient, the owners elected humane euthanasia and necropsy was performed. The mediastinal mass was consistent with an ectopic thyroid carcinoma, and the pulmonary nodules represented equine multinodular pulmonary fibrosis (EMPF). This case report describes a type of mediastinal tumor not previously described in horses. Moreover, it shows the need of including EMPF as a possible differential diagnosis for a nodular interstitial pulmonary pattern in conjunction with a mediastinal or other masses.
Topics: Animals; Herpesviridae Infections; Horse Diseases; Horses; Male; Mediastinum; Pulmonary Fibrosis; Thyroid Neoplasms
PubMed: 31133322
DOI: 10.1016/j.jevs.2019.02.016