1/19. Giant localized fibrous mesothelioma: an unusual large intrathoracic tumor.BACKGROUND: Localized fibrous mesotheliomas are rare intrathoracic tumors arising from the pleural tissue. They are mostly benign tumors, with dimensions ranging from a small nodule to a large intrathoracic tumor. CASE: This paper describes the presence of giant localized fibrous mesothelioma filling the lower left pleural cavity, which developed over a 20-year period. Surgical resection of the tumor showed a large, localized fibrous mesothelioma 14 cm in diameter. CONCLUSIONS: The clinical manifestations of localized fibrous mesotheliomas are very variable. Small tumors may be asymptotic, while large tumors may cause respiratory, cardiac or metabolic symptoms. Complete surgical resection is the preferred treatment and is usually curative. Careful follow-up is indicated because recurrence may occur, even many years after the initial operation.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/19. Huge malignant localized fibrous tumor of the pleura.Localized fibrous tumor is an unfrequent mesenchymal neoplasm. The malignant variant of the pleura is exceptional and differential diagnosis with the more frequent benign type or with other neoplasms such as soft tissue sarcoma and mesothelioma is rarely possible in a preoperative setting. The best treatment of this disease is radical surgical resection. No definitive data exist about the role of chemotherapy. We report a case of a giant right intrathoracic mass whose preoperative diagnosis, from an open biopsy, was consistent with sarcoma and, in a second review, with fibrous tumor of the pleura without any indication about malignancy. A right pleuropneumonectomy and pericardial resection was performed through a right hemiclam-shell approach. histology demonstrated an aggressive behaviour: high mitosis rate, Ki 67 of 34% and diffuse necrosis were present. In consideration of the apparent local radicality we did not perform any adjuvant treatment. Six months after the operation a wide local recurrence was evident and a systemic treatment with ifosfamide and Adriamicina is still in progress. So far a good response has been documented. Preoperative diagnosis of malignancy has an important role as a therapeutic strategy in management of fibrous tumours of the pleura. When there is suspicion of a malignant form neoadjuvant chemotherapy can represent a further tool to control poorly differentiated and large tumors, and a wide surgical resection of the lesion must be performed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/19. Pleural amyloidosis mimicking mesothelioma: a clinicopathologic study of two cases.Two cases of pleural amyloidosis are presented. The patients are two men, 70 and 72 years of age respectively. Neither patient had evidence of systemic amyloidosis. Each presented clinically with symptoms of chest pain and dyspnea. Radiologically, both patients showed diffuse pleural thickening similar to that observed in malignant mesothelioma. In both patients, surgical decortication of the pleura was performed. Histologically, the lesions were characterized by the presence of an amorphous eosinophilic material with focal collections of a lymphoplasmacytic infiltrate. Focal clusters of giant cells were admixed with the lymphoplasmacytic infiltrate. Histochemical stains for congo red showed strong positive apple-green birefringency. Immunohistochemical studies using kappa and lambda light chains showed polyclonality. The cases discussed herein represent an unusual presentation of amyloid and one that needs to be considered in the differential diagnosis of malignant mesothelioma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/19. Severe hypoglycaemia associated with a giant solitary fibrous tumor of the pleura.solitary fibrous tumors (SFT) of the pleura are a rare neoplasm, with benign biological behaviour. Recurrences are rare, and no distant metastases are described in the literature. SFT can secrete hormone-like substances, responsible for paraneoplastic syndromes. The authors describe a case of severe hypoglycaemia due to insulin-like growth factor ii (IGF-2)'s secretion by a giant SFT of the pleura. Hypoglycaemia was controlled by the resection of the tumor. diagnosis and surgical management of these neoplasms are also discussed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/19. Giant benign fibrous tumor of the pleura in a pregnant woman: report of a case.While most pleural neoplasms are malignant and associated with asbestos exposure, benign tumors may also occur. Benign fibrous tumors of the pleura are rare and, unless diagnosed and resected early, they may reach an enormous size and cause severe symptoms. We report the case of a pregnant woman with a giant benign fibrous tumor localized in the pleura.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/19. Giant pleural fibroma with an abdominal vascular supply mimicking a pulmonary sequestration.A 37 -year-old woman was found to have a giant mass in her right chest with an abnormal abdominal vascular supply at preoperative workup. Suspecting a pulmonary sequestration, the lesion was embolized and then removed through a standard thoracotomy. A broad-based, vascularized pedicle connected the mass to the diaphragm. Final pathology demonstrated a solitary fibrous tumor of the pleura with no malignant features. We believe this is the first case of solitary fibrous tumor of the pleura with a direct vascular supply from the abdominal aorta at the level of the renal arteries reported in the literature.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/19. Malignant pleural mesothelioma producing human chorionic gonadotropin. Report of two cases.Two cases of malignant pleural tumor producing human chorionic gonadotropin, one confirmed at surgery and autopsy and the other by biopsy, are reported. Both of the patients had bilateral gynecomastia with high levels of serum human chorionic gonadotropin. The first patient underwent panpleuropneumonectomy because of diffuse malignant pleural tumor, but died five months later due to recurrent disease. The histological diagnosis was diffuse, malignant, monophasic mesothelioma of the epithelial type. Immunostaining for alpha-, beta-human chorionic gonadotropin and human placental lactogen was positive in syncytiotrophoblast-like cells. The second patient had diffuse pleural tumor with massive effusion. A pleural biopsy specimen showed diffuse proliferation of epithelioid large cells. Immunostaining for alpha, beta-human chorionic gonadotropin and human placental lactogen was positive in mono- and multinucleated bizarre giant cells mimicking trophoblasts. A diagnosis of malignant mesothelioma with trophoblastic differentiation seemed most likely in both cases in view of the clinical and pathological findings. In both cases, results of mucin histochemistry and various immunohistochemical stains for antigens or with antibodies were consistent with diagnosis of mesothelioma except in a few cells in the choriocarcinomatous portion. This may be the first report describing human chorionic gonadotropin-producing malignant mesotheliomas of the pleura.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/19. Huge localized fibrous tumor of the pleura resembling a mediastinal tumor: report of a case.A 67-year-old man was admitted to our hospital because of an abnormal chest echoic lesion detected incidentally by echocardiography. A chest roentgenogram showed the presence of a giant mass, and computed tomography of the chest confirmed the presence of a mass with a nonhomogeneous density in the left mediastinum, just adjacent to the left ventricle of the heart. Percutaneous aspiration cytology of the mass showed benign fibrous cells and a small amount of lymphocytes. The preoperative diagnosis of the tumor suggested a thymoma, and the patient underwent a thoracotomy. A pedunculated tumor arose from the visceral pleura of the left upper lobe of the lung, and it was capsulated within the pleura. The tumor measured 15 x 12 x 8 cm in size and it was successfully resected. The pathological diagnosis of the tumor was benign localized fibrous tumor of the pleura.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/19. Malignant melanoma of pleura in a patient with giant congenital "bathing suit" hairy nevus.An unusual case of malignant melanoma of the pleura in a patient with "bathing-suit" type of giant congenital hairy nevus is presented. The treatment advocated and the outcome are discussed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
10/19. Two cases of secondary soft tissue sarcomas after radiotherapy and radiochemotherapy.BACKGROUND: The development of secondary soft tissue sarcomas after chemo-radiotherapy is a rare and little known event, but its frequency is increasing. patients AND methods: We report two cases of secondary soft tissue sarcomas. The first is the case of a 51-year-old woman treated for Hodgkin's disease with chemotherapy and radiotherapy 15 years before she developed a high-grade malignant pleural sarcoma. The patient had no history of asbestos exposure. The second is the case of a 64-year-old woman with a giant cell malignant histiocytoma secondary to colorectal cancer treated with surgery and radiotherapy nine years before. The patients were not eligible for surgery or radiotherapy. Both were treated with chemotherapy (ifosfamide and epirubicin) without any relevant secondary effects; however, the response to therapy was poor. CONCLUSIONS: The causes of secondary malignancies are multifactorial, but radiation therapy and chemotherapy are certainly implicated in the development of post-therapy neoplasms that are difficult to treat.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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