1/287. Mediastinal lymph node metastasis of colon cancer: report of a case.We herein describe a patient with mediastinal lymph node metastases which occurred after both a primary sigmoid colon cancer and metachronous ovarian metastasis had been resected. The most likely route of metastases to the mediastinum in this case is the paravertebral venous plexus probably connected to the ovarian metastasis, or so-called remetastasis. This case illustrates that the mediastinum is thus a possible metastatic site in patients with colon cancer. Surgeons should therefore pay attention to the mediastinum as well as the lung fields when checking chest X-ray films during a follow-up of patients after a resection of colon cancer.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/287. Mediastinal choriocarcinoma in a chromatin-positive boy.A case of primary mediastinal choriocarcinoma in a chromatin-positive boy is reported. The incidence of neoplasms in patients with so-called Klinefelter's syndrome is discussed as well as embryogenesis and diagnostic evaluation in patients presenting with this tumor.- - - - - - - - - - ranking = 1.7831479280107keywords = neoplasm (Clic here for more details about this article) |
3/287. A new observation of the Carney's triad with long follow-Up period and additional tumors.The etiology of the Carney's triad (gastrointestinal stromal tumors, pulmonary chondromas, and paragangliomas) is unknown, and only 57 cases have been reported since its identification in 1977. We report the clinical course of a female with the complete triad and some additional tumors. Bilateral vagal paragangliomas were treated surgically and with radiotherapy between the ages of 24 and 26 years. Subsequently she underwent surgery for a gastric leiomyosarcoma (27 years), a pleomorphic adenoma of the parotid gland (49 years) and a multifocal breast cancer with axillary spread (50 years). A calcified lesion was also noticed in the left lung, the radiologic diagnosis of which was consistent with chondroma. A mediastinal paraganglioma, detected at 56 years on a control X-ray of the chest, was partially excised at 63 years. At the last control, performed at 66 years, the patient was alive with residual cervical and mediastinal paraganglioma. Her younger brother was affected by Hirschsprung's disease and died at 54 years of rectal cancer. Her daughter is 33 and has been suffering since birth with severe constipation. In conclusion, this is one of the longest followed-up patients with Carney's triad. Her case illustrates the need for early recognition of the setting in order to detect the component tumors at a stage when surgery may be curative, and careful and life-long follow-up, both because the multicentricity of the classic components tends to manifest metachronously and because of the tendency to develop other tumors, some of which may be malignant. Furthermore, the presence of Hirschsprung's disease in the patient's family, coupled with the alleged common origin of two component lesions from derivatives of the neural crest, open new avenues for the understanding of this disorder.- - - - - - - - - - ranking = 0.28571428571429keywords = cancer (Clic here for more details about this article) |
4/287. Amphicrine tumor.The term amphicrine refers to cells, and tumors, which show both exocrine and endocrine features. Author s aim was to analyse the characteristics of these neoplasms. 40 suspicious cases were reviewed. Mucin-stains (PAS, diastase-PAS, Stains-all, Alcian-blue), immunohistochemistry (antibodies against Neuron-Specific Enolase (NSE), and chromogranin a (CGA), and electronmicroscopic studies were performed to demonstrate exocrine and/or endocrine features of the tumor cells. By means of these methods, 16 cases turned out to be amphicrine tumors. Among them, there were 4 sinonasal, 1 bronchial, 1 mediastinal, 8 gastrointestinal and 2 suprarenal gland neoplasms. In connection to the subject, a brief review is given of amphicrine tumor, regarding its etiological and pathological aspects. These tumors form a distinct clinicopathological entity and should be separated from both neuroendocrine tumors and adenocarcinomas.- - - - - - - - - - ranking = 3.5662958560213keywords = neoplasm (Clic here for more details about this article) |
5/287. Giant cell tumor of the thoracic spine simulating mediastinal neoplasm.A case of giant cell tumor of the thoracic spine simulating mediastinal neoplasm was identified on plain films, CT scans, MR images, and with scintigraphy. CT showed a hypervascular soft-tissue mass with shell-like calcification in the right upper mediastinum. MR imaging showed a collapse of the T1 vertebral body and a mass extending to the mediastinum. The mass had a low signal on T1-weighted MR images and a predominantly high signal on T2-weighted images with heterogeneity. technetium-99m methylene diphosphonate bone scintigraphy showed intense uptake in both the T1 and marginal parts of the mediastinal mass. There was no accumulation of gallium-67 citrate, but 18-fluorine fluorodeoxyglucose positron emission tomography showed marked uptake. The variation in these imaging findings played an important role in the differential diagnosis of this uncommon mediastinal mass.- - - - - - - - - - ranking = 8.9157396400533keywords = neoplasm (Clic here for more details about this article) |
6/287. Metastatic paraganglioma and paraneoplastic-induced anemia in an adolescent: treatment with hepatic arterial chemoembolization.Mediastinal paragangliomas are rare neoplasms in children. anemia, as a paraneoplastic syndrome, has been described in adults with metastatic paraganglioma. The management of paraneoplastic anemia from metastatic paraganglioma has been problematic, with no reports in the literature describing successful treatment. This article describes a 17-year-old Jehovah's Witness with a mediastinal paraganglioma, hepatic metastases, and severe anemia. The patient and his family refused blood products and the anemia was refractory to erythropoietin and elemental iron therapy. Serial chemoembolization of the hepatic lesions resulted in resolution of the anemia, allowing subsequent debulking of the mediastinal paraganglioma.- - - - - - - - - - ranking = 1.7831479280107keywords = neoplasm (Clic here for more details about this article) |
7/287. Anesthetic managements of the patients with giant mediastinal tumors--a report of two cases.anesthesia for patients with a huge anterior mediastinal tumor is a well-known challenge and trial to all the anesthesiologists. The tumor mass which directly compresses the trachea and bronchus induces hypoxia and asphyxia, eventuating in cardiac arrest or even fatality in the process of general anesthesia. In selection of anesthetic technique, general anesthesia is deliberately avoided if not mandatory or spontaneous respiration should be strictly preserved by all means if obligatory. Our surgical colleagues are usually not so familiar with this potentially life-threatening situation as are the anesthesiologists, and bad communications and interactions between the two may court disaster. Here we reported 2 cases: the former was an immediate mortality in a youth with a giant anterior mediastinal tumor undergoing excisional biopsy of a neck mass under general anesthesia, and the latter was a successful anesthetic management in a woman with a giant mediastinal tumor receiving abdominal total hysterectomy for cervical cancer in situ under spinal anesthesia. The hazards of general anesthesia in these patients and the importance of comprehending preanesthetic preparations were reviewed and discussed. Moreover, we address that whenever one has shot his bolt still futile to improve the respiratory crisis in a case with mediastinal tumor, try to ventilate the patient in a prone position as it has clinical importance in ventilation and oxygenation.- - - - - - - - - - ranking = 0.14285714285714keywords = cancer (Clic here for more details about this article) |
8/287. Hurthle cell adenoma of the mediastinum: intraoperative cytology and differential diagnosis with correlative gross, histology, and ancillary studies.A 66-year-old man was found to have a 7.5 cm mediastinal mass detected on routine chest x-rays as part of his preoperative work up for an inguinal hernia repair. An orthotopic (normally located) nongoitrous thyroid gland without evidence of connection to the mediastinal mass was also identified. The clinical differential diagnoses included lymphoma, thymoma, and germ cell tumor. Fine-needle aspiration (FNA) biopsy smears and touch imprints of the mediastinal mass showed a loosely cohesive, highly cellular population of relatively uniform cells with abundant granular cytoplasm, low nuclear to cytoplasmic (N/C) ratios, and prominent nucleoli consistent with a Hurthle cell (HC) neoplasm. Subsequently, the diagnosis of HC adenoma was confirmed on the surgically excised mediastinal mass. To the best of our knowledge, the surgical pathology and cytologic features of an HC adenoma of the mediastinum have not been reported in the literature. The gross, histologic, immunohistochemical, and electron microscopic (EM) findings, in addition to the cytologic features, are presented along with a differential diagnosis of this mediastinal neoplasm.- - - - - - - - - - ranking = 3.5662958560213keywords = neoplasm (Clic here for more details about this article) |
9/287. Sudden death in a child due to an intrathoracic paraganglioma.A 12-year-old boy under treatment for asthma was found dead in his home. The autopsy revealed a large posterior mediastinal mass that completely compressed the upper lobe of the right lung and the associated airways. This mass extended from the right costovertebral sulcus into the thoracic spinal canal through the spinal foramen and compressed the spinal cord. It was located in the epidural space and was adherent to a nerve root. The histologic and immunocytochemical features were that of a paraganglioma. Although neurogenic tumors are the most common posterior mediastinal masses in the pediatric population, paragangliomas are rare, and spinal involvement has not been described in children. In addition, sudden death has not been reported in association with any of the 13 cases of posterior mediastinal paraganglioma described in the literature as involving the spine. This case illustrates an unusual cause of sudden death in a pediatric patient due to a benign neoplasm.- - - - - - - - - - ranking = 1.7831479280107keywords = neoplasm (Clic here for more details about this article) |
10/287. Cytokeratin-positive malignant tumors with reticulum cell morphology: a subtype of fibroblastic reticulum cell neoplasm?Cytokeratin-positive interstitial reticulum cells (CIRCs) have been described as a subset of fibroblastic reticulum cells (FBRCs) normally found in lymph nodes, the spleen, and tonsils. Although tumors derived form other reticulum (dendritic) cells, specifically follicular dendritic cells, interdigitating dendritic cells, and cytokeratin-negative FBRCs, have been well documented and are now accepted, this is not the case for tumors of CIRCs. A possible reason for this failure is the difficulty in distinguishing them from other tumors, particularly carcinoma. We report three cases of cytokeratin-positive malignant tumors with a reticulum cell morphology: two located in the mediastinum and one in the soft tissue in the proximal forearm. All cases coexpressed vimentin, and one case coexpressed smooth muscle actin and desmin, resulting in a phenotype similar to that of some normal CIRCs. Although metastatic carcinoma from an occult or regressed primary tumor cannot be excluded completely, we raise the possibility of a CIRC origin for these cases.- - - - - - - - - - ranking = 7.1491781047302keywords = neoplasm, spleen (Clic here for more details about this article) |
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