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Thoracic Cancer Mar 2020While cavernous hemangioma are frequently observed in various tissues and locations in the body, mediastinal cavernous hemangiomas (CHMs) are rare, particularly in the...
While cavernous hemangioma are frequently observed in various tissues and locations in the body, mediastinal cavernous hemangiomas (CHMs) are rare, particularly in the middle mediastinum. Here, we report a case of a middle CHM which was diagnosed and treated in our hospital. A male patient age 57 years was admitted with a mediastinal circular low-density lesion. Preoperative examination was performed with a subsequent diagnosis of a mediastinal lesion. The lesion was resected and post-operative histopathology suggested that it was a cavernous hemangioma. Post-operative recovery was uneventful, and a follow-up examination nearly one year later showed that the patient had no recurrence.
Topics: Hemangioma, Cavernous; Humans; Male; Mediastinal Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Postoperative Period; Prognosis
PubMed: 31944605
DOI: 10.1111/1759-7714.13301 -
Praxis Mar 2013
Topics: Adult; Angiography; Aortic Aneurysm; Biopsy; Diagnosis, Differential; Hemothorax; Humans; Magnetic Resonance Angiography; Male; Mediastinal Diseases; Mediastinal Neoplasms; Mediastinoscopy; Mediastinum; Neoplasm Staging; Risk Factors; Sarcoma, Synovial; Tomography, X-Ray Computed
PubMed: 23531903
DOI: 10.1024/1661-8157/a001266 -
Haematologica Jan 2017Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been...
Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B-cell lymphoma immunophenotype, primary mediastinal B-cell lymphoma-like morphology (30.3%) with classical Hodgkin lymphoma or composite (5.1%) (synchronous occurrence of classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma). The median age was 32 years (13-83 years); 55% were women. Thirteen of 81 evaluable cases (16%) were Epstein-Barr virus-positive. Twenty-eight percent of patients presented primary refractory disease (progression under first-line treatment or relapse within one year). The 3-year event-free and overall survival rates were 63% and 80%, respectively. Patients treated with a standard regimen (RCHOP/ABVD) had worse event-free survival (P=0.003) and overall survival (P=0.02) than those treated with a dose-intensive chemotherapy (high-dose RCHOP/escalated BEACOPP). Rituximab added to chemotherapy was not associated with better event-free survival (P=0.55) or overall survival (P=0.88). Radiotherapy for patients in complete remission had no impact on event-free survival. In multivariate prognostic analysis, ECOG-PS and anemia were the strongest factors associated with a shorter event-free survival and overall survival, respectively. In conclusion, this report describes the largest series of mediastinal gray zone lymphoma. Our data suggest that a dose-intensive treatment might improve the outcome of this rare and aggressive disease.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy; Bone Marrow; Combined Modality Therapy; Disease Progression; Female; Follow-Up Studies; Humans; Immunohistochemistry; Immunophenotyping; Lymphoma, B-Cell; Male; Mediastinal Neoplasms; Middle Aged; Neoplasm Staging; Prognosis; Recurrence; Retrospective Studies; Survival Analysis; Treatment Outcome; Young Adult
PubMed: 27758822
DOI: 10.3324/haematol.2016.152256 -
Oncology (Williston Park, N.Y.) Mar 2014
Review
Topics: Adolescent; Adult; Age Factors; Diagnostic Imaging; Female; Hodgkin Disease; Humans; Mediastinal Neoplasms; Neoplasm Staging; Predictive Value of Tests; Sex Factors; Treatment Outcome; Tumor Burden; Young Adult
PubMed: 24855735
DOI: No ID Found -
Medicine Apr 2024Posterior mediastinal leiomyosarcoma is an extremely rare malignant mesenchymal tumor with no special clinical symptoms, which is easily confused with some common tumors... (Review)
Review
BACKGROUND
Posterior mediastinal leiomyosarcoma is an extremely rare malignant mesenchymal tumor with no special clinical symptoms, which is easily confused with some common tumors in the posterior mediastinum, affecting the accuracy of the first diagnosis by clinicians and delaying the treatment of patients.
CASE SUMMARY
We report a 59-year-old woman with a space-occupying lesion in the posterior mediastinum. The patient was mistakenly diagnosed with lumbar muscle or vertebral body lesions due to chest and back pain and underwent conservative treatment, but her symptoms did not improve significantly and she gradually developed pain in both lower limbs. Chest computed tomography (CT) scan indicated the left lower lung paraspinal space and underwent standard single-aperture video-assisted thoracoscopic surgery (VATS), which was pathologically confirmed as posterior mediastinal leiomyosarcoma.
CONCLUSION
Complete surgical resection of posterior mediastinal leiomyosarcoma can achieve good clinical results.
Topics: Humans; Female; Middle Aged; Mediastinum; Leiomyosarcoma; Mediastinal Neoplasms; Thorax; Tomography, X-Ray Computed
PubMed: 38579068
DOI: 10.1097/MD.0000000000037704 -
International Journal of Molecular... Oct 2021Germ cell tumors (GCTs) are considered to be highly curable; however, there are major differences in the outcomes related to histology and anatomical localization. GCTs...
Germ cell tumors (GCTs) are considered to be highly curable; however, there are major differences in the outcomes related to histology and anatomical localization. GCTs originating from the testis are, overall, sensitive to platinum-based chemotherapy, whereas GCTs originating from the mediastinum show a worse response, which remains largely unexplained. Here, we address the differences among GCTs from two different anatomical locations (testicular versus mediastinal/extragonadal), with a specific focus on the role of the P53 pathway. It was recently shown that GCTs with mutations most often localize to the mediastinum. To elucidate the underlying mechanism, knock-out lines were generated in cisplatin-sensitive and -resistant clones of the representative 2102Ep cell line (wild-type testicular GCT) and NCCIT cell line (hemizygously mutated , mutant mediastinal GCT). The full knock-out of in 2102Ep and resistant NCCIT resulted in an increase in cisplatin resistance, suggesting a contributing role for P53, even in NCCIT, in which P53 had been reported to be non-functional. In conclusion, these results suggest that mutations contribute to the cisplatin-resistant phenotype of mediastinal GCTs and, therefore, are a potential candidate for targeted treatment. This knowledge provides a novel model system to elucidate the underlying mechanism of clinical behavior and possible alternative treatment of the mutant and mediastinal GCTs.
Topics: Antineoplastic Agents; Cell Line, Tumor; Cisplatin; Drug Resistance, Neoplasm; Gene Expression Regulation, Neoplastic; Humans; Male; Mediastinal Neoplasms; Mutation; Neoplasms, Germ Cell and Embryonal; Testicular Neoplasms; Tumor Suppressor Protein p53
PubMed: 34769213
DOI: 10.3390/ijms222111774 -
BMC Cancer Apr 2017The purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma...
BACKGROUND
The purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma (PMLBCL) as they have been matter of debate for at least two decades.
METHODS
Our single centre experience in the treatment of 98 de novo PMLBCL patients over the last 20 years is reviewed. All patients received MACOP-B chemotherapy. Thirty-seven received both rituximab and mediastinal radiotherapy; 30 were irradiated after chemotherapy, although not receiving rituximab and 20 received rituximab without radiotherapy consolidation. Eleven patients received chemotherapy only.
RESULTS
Sixty-one (62.2%) patients achieved a complete response after MACOP-B (with or without rituximab); among the 27 (27.6%) partial responders, 21 obtained a complete response after radiotherapy. At the end of their scheduled treatment, 82 patients (83.7%) had a complete and 6 a partial response (6.1%). Eleven patients relapsed within the first 2 years of follow-up. The 17-year overall survival is 72.0% (15 patients died); progression-free and disease-free survival are 67.6% and 88.4%, respectively. A statistically significant difference in overall and progression-free survival was noted among treatment groups, although no disease-free survival difference was documented.
CONCLUSIONS
Our data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. Mediastinal consolidation radiotherapy impacts on survival and complete response rates and remains a good strategy to convert partial into complete responses. Data suggest that radiotherapy may be avoided in patients obtaining a complete response after (immuno)chemotherapy, but this requires confirmation with further ad hoc studies.
Topics: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Female; Humans; Immunotherapy; Leucovorin; Lymphoma, Large B-Cell, Diffuse; Male; Mediastinal Neoplasms; Methotrexate; Middle Aged; Neoplasm Staging; Prednisone; Retrospective Studies; Rituximab; Vincristine; Young Adult
PubMed: 28415982
DOI: 10.1186/s12885-017-3269-6 -
BMC Cancer Jun 2021Surgery is still the mainstay of radical treatment for resectable esophageal cancer (EC). It is apparent that the presence or spread of lymph node metastasis (LNM) is a...
BACKGROUND
Surgery is still the mainstay of radical treatment for resectable esophageal cancer (EC). It is apparent that the presence or spread of lymph node metastasis (LNM) is a powerful prognostic factor in patients with EC who are eligible for curative treatment. Although the importance and efficacy of lymph node dissection in radical esophagectomy have been reported, the clinical or prognostic relevance of specific metastatic patterns within the mediastinal cavity and abdomen remains unclear.
METHODS
We retrospectively analyzed the association of postoperative survival with clinical mediastinal LNM (cMLNM) and abdominal LNM (cALNM) in 157 patients who underwent radical EC surgery at our hospital between May 2012 and March 2018.
RESULTS
A significant difference in cause-specific survival (CSS) was observed between patients with and without cALNM (log-rank p = 0.000). A multivariate Cox regression analysis revealed that cALNM and thoracic surgery (mediastinal lymphadenectomy via conventional open right thoracotomy or video-assisted thoracoscopic surgery) independently predicted CSS (p = 0.0007 and 0.021, respectively). Moreover, a significant difference in systemic recurrence-free survival was observed between those with and without cALNM (log-rank p = 0.000). Multivariate Cox regression analysis revealed that cALNM and sex independently predicted systemic recurrence-free survival (p = 0.000 and 0.015, respectively).
CONCLUSION
cALNM was an independent poor prognostic factor for CSS after EC surgery. It may also be an independent prognostic factor for postoperative systemic recurrence, which can shorten the CSS. For patients with cALNM-positive EC who have a high potential risk of systemic metastases, more extensive treatment besides the conventional perioperative systemic chemotherapy may be necessary.
Topics: Abdominal Neoplasms; Aged; Esophageal Neoplasms; Female; Humans; Male; Mediastinal Neoplasms; Neoplasm Metastasis; Prognosis; Retrospective Studies; Survival Analysis; Treatment Outcome
PubMed: 34162359
DOI: 10.1186/s12885-021-08484-2 -
Revista Do Colegio Brasileiro de... 2017Mediastinum tumors may grow slowly and reach giant proportions without symptoms, hindering surgical removal. Tumor big dimensions difficult surgical maneuvers, with risk...
Mediastinum tumors may grow slowly and reach giant proportions without symptoms, hindering surgical removal. Tumor big dimensions difficult surgical maneuvers, with risk of uncontrollable bleeding and prejudice to surrounding structures. It may be necessary the use of exceptional measures such as venous-venous circulatory deviation, pre-operatory embolization and total extracorporeal circulation. We describe the technique of tumor lamination that allows for complete or almost complete resection of such tumors that in many occasions are not resectable. The description is based on the results of four patients treated with mediastinum giant tumors.
Topics: Humans; Mediastinal Neoplasms; Surgical Procedures, Operative; Tumor Burden
PubMed: 29267563
DOI: 10.1590/0100-69912017006007 -
Journal of Cardiothoracic Surgery Feb 2023Thymic clear cell carcinoma is a rare mediastinal neoplasm, with only 25 reported cases to date. We report a case of a 45-year-old man with thymic clear cell carcinoma.... (Review)
Review
BACKGROUND
Thymic clear cell carcinoma is a rare mediastinal neoplasm, with only 25 reported cases to date. We report a case of a 45-year-old man with thymic clear cell carcinoma. We think imaging and laboratory tests may be helpful for differential diagnosis.
CASE PRESENTATION
A 45-year-old male was admitted to a local hospital for chest distress with cardiopalmus. CT showed a mediastinal mass. Laboratory examination results were all in the normal range. Histologically, the tumor cells had a clear cytoplasm, and immunohistochemically, the tumor cells were positive for epithelial markers. We performed abdominal and pelvic CT and further examined serum levels of thyroxine, parathyroid hormone and AFP postoperatively, which were normal. The patient received postoperative radiotherapy, and CT showed left adrenal metastasis at 20 months after surgery.
CONCLUSION
Thymic clear cell carcinoma is a rare malignant neoplasm. Adrenal metastasis can occur. Patients undergo thymectomy with chemotherapy or with radiotherapy have better outcoming. Metastasis, direct invasion of parathyroid carcinoma and other primary tumors in the mediastinum should be excluded. Immunohistochemical markers, imaging and laboratory examination can help to exclude metastasis.
Topics: Male; Humans; Middle Aged; Thymus Neoplasms; Thymoma; Mediastinal Neoplasms; Mediastinum; Carcinoma
PubMed: 36726176
DOI: 10.1186/s13019-023-02150-3