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1.
Medicine (Baltimore) ; 98(49): e18276, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804368

RESUMO

RATIONALE: Pulmonary benign metastasizing leiomyoma (PBML) is rare, usually occurs in women who underwent hysterectomy during the reproductive years, and has no obvious clinical symptoms. A full understanding of the characteristics of PBML is important for its sequential treatment and prognosis. PATIENT CONCERNS: In this report, a 36-year-old female patient with previous uterine leiomyoma who underwent 3 surgical resections of the uterus, bilateral fallopian tubes, and partial omentum was investigated. The physical examination revealed a tumor in the right lower lobe and mediastinum and a solid nodule in the right middle lobe. DIAGNOSES: Chest computed tomography (CT) confirmed a tumor in the right lower lobe and mediastinum and a solid nodule in the right middle lobe. Further positron-emission tomography computed tomography (PET-CT) with 18F-fluorodeoxyglucose (FDG) of the whole body showed mildly intense accumulation of 18F-FDG in the tumor (maximum standardized uptake value [SUV max], 2.6). A pathological examination then confirmed the presence of fibrous and vascular tissue after CT-guided percutaneous biopsy of the tumor in the right lower lobe. Additionally, surgical resection of the tumor and nodule was performed for histological analysis and immunohistochemical assays for estrogen receptor (ER) and progesterone receptor (PR). INTERVENTIONS: The patient underwent complete tumor surgical resection and nodule wedge resection. OUTCOMES: No postoperative complications occurred. No recurrence or other signs of metastasis were found during an 18-month follow-up observation period. CONCLUSION: In this case, lung and mediastinal metastasis of uterine fibroids was observed. However, depending on only a postoperative histological analysis is insufficient for the diagnosis of PBML. Histological analysis combined with an evaluation of the expression levels of ER and PR is crucial for the diagnosis and treatment of PBML.


Assuntos
Leiomioma/patologia , Neoplasias Pulmonares/secundário , Neoplasias do Mediastino/secundário , Neoplasias Uterinas/patologia , Adulto , Feminino , Humanos , Biópsia Guiada por Imagem , Leiomioma/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Neoplasias Uterinas/cirurgia
2.
J Cardiothorac Surg ; 14(1): 182, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31665049

RESUMO

BACKGROUND: The authors presented a 63-year old female synchronously complicated with a thymic tumor located at the left-side of the superior mediastinum, and a paravertebral tumor located at the right-side of the lower thorax. Conventional thoracoscopic surgical procedure using rigid instruments to simultaneously resect the two tumors via the same ports might be technically challenging. To our knowledge, the use of a surgical robot allowed the surgeon to perform precise dissection from extreme angles with the characteristic of articulating surgical instruments. CASE PRESENTATION: Two lesions were successfully dissected using the da Vinci Surgical System through the same four ports on the right side of the chest and two-step docking. Firstly, the patient cart came from the dorsal side of the patient and the paravertebral neoplasm was dissected. Afterwards, the patient cart was undocked and the operation table was rotated 180 degrees counterclockwise. The robot was re-introduced and the patient cart came from the ventral side of the patient and the whole thymus was resected. CONCLUSION: This case report suggests that two-step docking via the same four ports for these two tumors located at different directions of the thorax was safe and effective, demonstrating a clear advantage of the surgical robot.


Assuntos
Cisto Broncogênico/cirurgia , Neoplasias do Mediastino/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Neurilemoma/cirurgia , Neoplasias do Timo/cirurgia , Cisto Broncogênico/diagnóstico por imagem , Cisto Broncogênico/patologia , Feminino , Humanos , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/patologia , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Procedimentos Cirúrgicos Robóticos/métodos , Vértebras Torácicas , Toracoscopia/métodos , Timectomia/métodos , Neoplasias do Timo/diagnóstico por imagem , Neoplasias do Timo/patologia , Tomografia Computadorizada por Raios X
3.
Medicine (Baltimore) ; 98(39): e17145, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574816

RESUMO

RATIONALE: Paragangliomas are rare neuroendocrine tumors that originate in specialized cells derived from the neural crest with metastasis to the thoracic spine being among the rarest forms. Here, we are presenting a detailed analysis of a case of malignant paraganglioma in the thoracic spinal region in a 14-year-old boy. Our focus is to emphasize the importance of considering malignant paraganglioma as a diagnosis and guiding the perioperative management upon surgical treatment. The management of these unique cases has yet to be well-documented. PATIENT CONCERNS: A 14-year-old boy presented with a 5-month history of continuous and progressive elevated blood pressure and back pain. The patient, who had been diagnosed of malignant paraganglioma in the left posterior mediastinum for 3 months, received surgical resection of paraganglioma in the left posterior mediastinum, which had involved the left intervertebral foramen of T4. However, the tumor was not completely resected during the first operation. DIAGNOSES: Magnetic resonance imaging of spine and positron emission tomography-computed tomography showed spinal cord compression secondary to the epidural component of the T4 mass, with increased marrow infiltration of the left T4 intervertebral foramen, which was difficult to be removed. Postoperative pathology confirmed the diagnosis of spinal involvement of malignant paraganglioma. INTERVENTIONS: The patient underwent biopsy and percutaneous vertebroplasty of T4 and paravertebral lesions, and needle-track cement augmentation via a posterior approach. OUTCOMES: The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 10-month follow-up visit. There were no other complications associated with the operation during the follow-up period. LESSONS: Combined efforts of specialists from orthopedics, neurosurgery, thoracic surgery, and medical oncology led to the successful diagnosis and management of this patient. Malignant paraganglioma of thoracic spine, although rare, should be part of the differential diagnosis when the patient has a history of paraganglioma and presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression of the malignant paraganglioma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation is also a good choice for surgical treatment. However, we need to take the potential risk of complications in bone cement applications into full consideration.


Assuntos
Neoplasias do Mediastino/cirurgia , Procedimentos Neurocirúrgicos/métodos , Procedimentos Ortopédicos/métodos , Paraganglioma/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adolescente , Descompressão Cirúrgica , Humanos , Masculino , Neoplasias do Mediastino/patologia , Paraganglioma/patologia , Neoplasias da Coluna Vertebral/patologia , Vértebras Torácicas/patologia , Vértebras Torácicas/cirurgia , Vertebroplastia/métodos
6.
Orv Hetil ; 160(37): 1476-1479, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31495185

RESUMO

A characteristics of mediastinal disorders is that the high anatomical density of vital structures in this region represents a challenge for diagnosis and surgical treatment. Space-occupying lesions can grow without causing overt manifestations - or can progress symptom-free - hence they can reach an extreme size by the time of surgery. A 58-year-old male patient was hospitalized for pleural effusion and an extensive, space-occupying mediastinal lesion, which had been causing respiratory symptoms for 15 years. Cytology of the pleural effusion did not confirm malignancy. The CT scan depicted progression manifested as an increase in the size of the lesion with a likely site of origin in the left adrenal gland. According to the MRI, by contrast, the lesion might have originated in the region of vertebrae Th9-10, as suggested by the lack of dural continuity. However, its adrenal origin could not be excluded either; endocrine activity was not detected. An operation was performed with a neurosurgeon included in the surgical team. A spinal tumor of the size of 20.2 by 11.1 by 10.8 cm was removed through thoraco-laparotomy, and reconstruction of the diaphragm was performed. Histology confirmed a schwannoma. Postoperatively, the expansion of the lung was only partial, because the patient discontinued respiratory rehabilitation. The follow-up CT scan depicted local recurrence. In the lack of alternative therapeutic modalities, surgical resection is usually the sole option for the management of large, mediastinal space-occupying lesions diagnosed at an advanced stage. Such operations should only be performed in specialist surgical centers and with multidisciplinary collaboration. Orv Hetil. 2019; 160(37): 1476-1479.


Assuntos
Neoplasias do Mediastino/cirurgia , Mediastino , Neurilemoma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Humanos , Laparotomia , Masculino , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neurilemoma/patologia , Neoplasias Retroperitoneais/patologia , Tomografia Computadorizada por Raios X
7.
J Cardiothorac Surg ; 14(1): 161, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500651

RESUMO

BACKGROUND: Pulmonary sarcomatoid carcinoma (PSC) is a rare malignancy with both epithelial and sarcoma components, and high tumor metastasis potential. CASE PRESENTATION: A 63-year-old male patient had a tumor in the right posterior mediastinum, and was eventually diagnosed with PSC and gingival metastasis. The patient underwent thoracoscopic right upper pneumonectomy with lymph node dissections, and the subsequent gingival biopsy revealed a metastatic PSC. The immunohistochemistry revealed that both PSC site tissues were positive for vimentin, CKAE1/AE3 and Ki-67. The patient received radiotherapy and chemotherapy after surgery, and deceased two months later due to systemic tumor metastases. CONCLUSION: PSC metastasis is variable, and leads to diagnostic dilemma or erroneous diagnosis. A differential diagnosis can help to distinguish it from gingival cancer.


Assuntos
Neoplasias Gengivais/secundário , Neoplasias do Mediastino/patologia , Sarcoma/secundário , Biópsia , Terapia Combinada , Diagnóstico Diferencial , Neoplasias Gengivais/diagnóstico , Neoplasias Gengivais/terapia , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Neoplasias do Mediastino/cirurgia , Mediastino , Pessoa de Meia-Idade , Pneumonectomia , Sarcoma/diagnóstico , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X
9.
J Cardiothorac Surg ; 14(1): 148, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387607

RESUMO

BACKGROUND: Mediastinal lipoma/liposarcoma is a rare tumor of the mediastinum. CASE PRESENTATION: This article reported one case of giant anterior superior mediastinum well-differentiated liposarcoma involving the left thoracic cavity with symptom of dysphagia. The mediastinum liposarcoma was completely resected through a left thoracotomy. Histologic examination and molecular pathological test clarified the diagnosis as well-differentiated mediastinal liposarcoma. There has been no evidence of recurrence during the 8 months follow-up. CONCLUSION: Molecular pathological examination of the MDM2, CDK4 and p16 gene in tumors provides the diagnostic gold standard in distinguishing well-differentiated liposarcoma from lipoma. Complete surgical resection is the first-line treatment choice for mediastinal lipoma/ liposarcoma.


Assuntos
Lipossarcoma/cirurgia , Neoplasias do Mediastino/cirurgia , Adulto , Transtornos de Deglutição/etiologia , Humanos , Lipoma/patologia , Lipossarcoma/complicações , Lipossarcoma/patologia , Masculino , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/patologia , Cavidade Torácica , Toracotomia
10.
J Craniofac Surg ; 30(5): e402-e404, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299792

RESUMO

Subglottic and mediastinal hemangioma are rare benign vascular tumors of childhood. They cause potentially life threatening condition which requires intervention. Several therapeutic options have been described in the literature with varying degrees of success and complications. We report a case of a stridulous 2-month old female infant with mediastinal and subglottic hemangioma. The child was treated with propranolol without the need for tracheostomy or any other surgical intervention, and with no reported side effects. Propranolol is an effective, non-invasive treatment for life threatening infantile hemangiomas compressing the airway, should be used as a firstline treatment for subglottic hemangiomas when intervention is required.


Assuntos
Hemangioma Capilar/cirurgia , Hemangioma/cirurgia , Neoplasias Laríngeas/cirurgia , Neoplasias do Mediastino/cirurgia , Feminino , Hemangioma/tratamento farmacológico , Hemangioma Capilar/tratamento farmacológico , Humanos , Lactente , Neoplasias Laríngeas/tratamento farmacológico , Neoplasias Laríngeas/patologia , Neoplasias do Mediastino/tratamento farmacológico , Neoplasias do Mediastino/patologia , Propranolol/uso terapêutico , Traqueostomia , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(26): e16252, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261591

RESUMO

RATIONALE: Massive mediastinal tumors present a major challenge for surgery and anesthesia management due to possible perioperative circulation and respiratory dysfunction. PATIENT CONCERNS: A 36-year-old female underwent difficulty with tracheal extubation and required mechanical ventilation for 3 months after resection of a massive mediastinal tumor. DIAGNOSES: Postoperative B-ultrasound examination of diaphragmatic motor weakness and electrophysiological examination indicated respiratory failure due to phrenic nerve injury. INTERVENTIONS: The patient failed tracheal extubation several times after the operation and finally a tracheotomy was performed. Mechanical ventilation, anti-infective treatment, and systemic supportive treatment were provided. OUTCOMES: The patient recovered well after tracheotomy and approximately 3 months of ventilation support. LESSONS: Weaning difficulty caused by phrenic nerve injury seriously affected patient postoperative rehabilitation. To reduce the occurrence of similar problems, intraoperative phrenic nerve electrophysiological monitoring should be conducted.


Assuntos
Extubação , Complicações Intraoperatórias/etiologia , Intubação Intratraqueal , Neoplasias do Mediastino/cirurgia , Nervo Frênico/lesões , Adulto , Feminino , Humanos
13.
Ann Thorac Surg ; 108(4): 1045-1051, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31181206

RESUMO

BACKGROUND: Nonintubated spontaneous ventilation video-assisted thoracoscopic surgery (NI-VATS) has been investigated to reduce the adverse effects of tracheal intubation, mechanical ventilation, and general anesthesia in several thoracic diseases. We comparatively assess the comparison between NI-VATS vs intubated anesthesia VATS (I-VATS) on early outcomes of mediastinal lesion resection. METHODS: Patients who underwent VATS resection for a mediastinal tumor between December 2015 and September 2018 were retrospectively included for analysis. Patients were divided into two groups according to anesthesia ventilation type: NI-VATS and I-VATS. Propensity score matching was applied to eliminate population bias. Intraoperative and postoperative variables were compared. RESULTS: A total of 198 patients was included; 75 patients underwent NI-VATS and 123 patients underwent I-VATS. After propensity score matching, both anesthesia time (173.81 vs 227.37 minutes, P < .001) and operation time (82.82 vs 133.49 minutes, P < .001) were shorter in the NI-VATS group. Bleeding (51.80 mL vs 56.73 mL, P = .90) and postoperative morbidity (10.9% vs 15.6%, P = .57) were similar between groups. Chest tube duration (1.11 vs 1.54 days, P = .04) was shorter in the NI-VATS group. Hospital duration after surgery (3.15 vs 5.35 days, P < .001) was shorter in the NI-VATS group. D-dimer after surgery was significantly higher in both groups, but NI-VATS decreased the change (577 vs 1624 µg/L, P < .001). Furthermore, a decrease in the use of postoperative opioids analgesics was seen in the NI-VATS group (31% vs 51%, P = .023). CONCLUSIONS: Mediastinal tumor resection is safe and feasible under NI-VATS. Better short-term outcomes suggest NI-VATS facilitates a more rapid recovery. Further multicenter prospective randomized investigation is warranted.


Assuntos
Anestesia Geral/métodos , Neoplasias do Mediastino/cirurgia , Complicações Pós-Operatórias/epidemiologia , Pontuação de Propensão , Cirurgia Torácica Vídeoassistida/métodos , China/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Intubação Intratraqueal , Masculino , Neoplasias do Mediastino/diagnóstico , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos
14.
J Pak Med Assoc ; 69(6): 902-904, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31201402

RESUMO

We report a case of a 28 year old female who presented to us in November 2016 with a swelling in front of neck for three years and worsening shortness of breath for last one year, causing right sided tracheal deviation and mildSuperior Vena Caval obstruction. X-ray showed a soft tissue density mass in antero-superior mediastinum with cephalad extension. Contrast enhanced CT neck and chest revealed a multi cystic lesion extending from the root of neck to anterior mediastinum causing compression and deviation of trachea, and nearby structures especially Superior Vena Cava (SVC) along with collateral formation. Mass was surgically excised from the neck and mediastinum with uneventful post-operative recovery. Histopathology was consistent with benign mature cystic teratoma.


Assuntos
Neoplasias do Mediastino/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Adulto , Dispneia/etiologia , Feminino , Humanos , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/cirurgia , Pescoço , Invasividade Neoplásica , Síndrome da Veia Cava Superior/etiologia , Teratoma/complicações , Teratoma/patologia , Teratoma/cirurgia , Tomografia Computadorizada por Raios X
16.
J Cardiothorac Surg ; 14(1): 113, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221172

RESUMO

BACKGROUND: Extralobar sequestration is a rare congenital malformation of lung tissue, which can be combined with other foregut and cardiac abnormalities. Our case is the first to report extralobar sequestration, absence of pericardium and atrial septal defect in the same patient. CASE PRESENTATION: A 22-year-old female with atrial septal defect came for her recent atypical symptom of intermittent palpitation and shortness of breath. Her computed tomography showed a cystic mass located in left superior anterior mediastinum near the pulmonary trunk. With specious of cystic teratoma prior to video-assisted thoracoscopic surgery, she finally was diagnosed as extralobar sequestration, while incidentally found with congenital absence of pericardium during surgery. CONCLUSIONS: Extralobar sequestration, absence of pericardium and atrial septal defect can occur in the same patient. The preoperative diagnostic rate of extralobar sequestration and asymptomatic absence of pericardium remains low attributed to atypical imaging features. A cardiac magnetic resonance imaging is highly recommended if necessary. Regular follow-up is essential to asymptomatic absence of pericardium and atrial septal defect patients. To patients with extralobar sequestration, an operation could be performed.


Assuntos
Sequestro Broncopulmonar/diagnóstico , Comunicação Interatrial/diagnóstico , Neoplasias do Mediastino/diagnóstico , Pericárdio/anormalidades , Teratoma/diagnóstico , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/cirurgia , Sequestro Broncopulmonar/complicações , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/cirurgia , Diagnóstico Diferencial , Feminino , Comunicação Interatrial/complicações , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/cirurgia , Humanos , Imagem por Ressonância Magnética , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Teratoma/complicações , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Monaldi Arch Chest Dis ; 89(2)2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31107038

RESUMO

Anterior mediastinal masses are relatively uncommon and include a wide variety of lesions. Lymphomas account for 25% of anterior mediastinal masses. Lymphomas and other haematological malignancies are associated with pericardial effusion. There are also cases where a cardiac tamponade occurred. The aim of the case reported herein is to discuss the surgical approach and particularly the mediastinal debulking as an adjunct to systematic treatment for haematological diseases presenting as an anterior mediastinal mass responsible for a cardiac tamponade.


Assuntos
Tamponamento Cardíaco/etiologia , Procedimentos Cirúrgicos de Citorredução , Leucemia-Linfoma de Células T do Adulto/cirurgia , Neoplasias do Mediastino/cirurgia , Humanos , Leucemia-Linfoma de Células T do Adulto/complicações , Masculino , Neoplasias do Mediastino/complicações , Adulto Jovem
18.
J Cardiothorac Surg ; 14(1): 96, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118058

RESUMO

BACKGROUND: This case highlights the challenges of preoperative differential diagnosis and management in a patient with an uncommon clinical presentation of giant intrathoracic teratoma. The age of the patient, location and size of the tumor, and clinical presentation makes this case unique. Typically, intrathoracic teratomas are found between the ages of 20-30, they are located in the anterior mediastinum, and tumors larger than 25 cm clinically present with cough or dysphagia. CASE PRESENTATION: A giant intrathoracic teratoma presents in a 51-year-old female as a mid to posterior mediastinal mass compressing the whole left lung with symptoms of depression, anorexia, unintentional weight loss, and cachexia. Due to her severe deconditioning she was optimized for 1 month in a skilled nursing facility with aggressive physical therapy and enteral nutrition. She underwent left thoracotomy with complete resection of the tumor. In follow up her BMI had improved, and she was regaining strength. CONCLUSIONS: Complete resection was achieved via left thoracotomy after aggressive rehabilitation.


Assuntos
Neoplasias do Mediastino/diagnóstico , Teratoma/diagnóstico , Caquexia/etiologia , Diagnóstico Diferencial , Dispneia/etiologia , Feminino , Humanos , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Pessoa de Meia-Idade , Teratoma/complicações , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Toracotomia
19.
BMJ Case Rep ; 12(5)2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068348

RESUMO

A 45-year-old man presents with acute respiratory failure. Imaging revealed a left mainstem endobronchial mass with subcarinal lymphadenopathy, but no other evidence of a primary tumour. An incidental laryngeal nodule was found during bronchoscopy. Biopsies of this lesion by nasopharyngoscopy and subcarinal lymph nodes via mediastinoscopy were performed. Histopathological and immunohistochemical examination showed evidence of melanoma in both samples. Mutational analysis identified the presence of a BRAFV600E mutation. The patient underwent bronchoscopic ablation of the left mainstem endobronchial tumour with laser therapy followed by initiation of encorafenib and binimetinib combination therapy. The patient remains alive at 4 months after initial presentation of disease. This case adds to the body of literature highlighting the clinical heterogeneity and challenges of the management of metastatic pulmonary melanoma. To the best of our knowledge, this simultaneous constellation of metastasis has not been described before.


Assuntos
Neoplasias Brônquicas/secundário , Neoplasias Laríngeas/secundário , Terapia a Laser , Metástase Linfática/patologia , Neoplasias do Mediastino/secundário , Melanoma/patologia , Biópsia por Agulha , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/cirurgia , Broncoscopia , Análise Mutacional de DNA , Humanos , Imuno-Histoquímica , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/cirurgia , Linfadenopatia , Metástase Linfática/diagnóstico por imagem , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento
20.
BMJ Case Rep ; 12(5)2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31079038

RESUMO

Ancient schwannoma is a distinctive type of schwannoma occurring mostly in the retroperitoneum. The presentation in the posterior mediastinum is rare. The term 'ancient' represents a group of neurogenic tumours showing degenerative changes with marked nuclear atypia. A 26-year-old man was incidentally detected to have an upper mediastinal mass lesion in the chest X-ray. MRI chest revealed a mixed signal intensity lesion in the left side upper para spinal region of the posterior mediastinum. The patient underwent left posterior thoracotomy and excision of the mass was done. Postoperative period was uneventful. The histopathological feature was typical of Ancient schwannoma. The patient is on regular follow-up and disease free until.


Assuntos
Neoplasias do Mediastino/patologia , Neurilemoma/patologia , Adulto , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Doenças Raras , Toracotomia/métodos , Tomografia Computadorizada por Raios X
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