Cases reported "Thoracic Neoplasms"

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1/23. Fine needle aspiration cytology of plexiform fibrohistiocytic tumor. A case report.

    BACKGROUND: Plexiform fibrohistiocytic tumors are rare lesions of proposed myofibroblastic origin occurring primarily in infants and children. While the histologic, immunohistochemical and ultrastructural findings have been well described, cytologic description has been limited. CASE: An 8-month-old, male infant presented with a posterior chest wall mass and decreased use of his left arm. Fine needle aspiration biopsy showed a spectrum of plump fibroblastic spindle cells and histiocytelike cells within a finely granular myxoid background. Osteoclastlike giant cells were also noted. CONCLUSION: We report here the cytologic findings of a plexiform fibrohistiocytic tumor from fine needle aspiration biopsy studied using Papanicolaou, Ultrafast Papanicolaou and Diff-Quik stain, with the cytologic differential diagnosis of other spindled and histiocytelike tumors.
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2/23. Successful transcutaneous arterial embolization of a giant hemangioma associated with high-output cardiac failure and kasabach-merritt syndrome in a neonate: a case report.

    We describe the case of a patient with a neonatal giant cutaneous hemangioma with high-output cardiac failure and kasabach-merritt syndrome and successfully treated with transcutaneous arterial embolization aimed at controlling severe congestive heart failure and consumption coagulopathy. A patient was admitted to the neonatal care unit on the first day of age because of a large hemangioma on his right lateral chest wall and respiratory distress, associated with cardiac failure resulting from arteriovenous shunting. On the second day of age the platelet count decreased to 5.7 x 10(4)/microliter and fibrinogen level was 85 mg/dl. The values of prothrombin time and activated partial thromboplastin time were prolonged. Intravenous predonisone therapy was started immediately, but bleeding tendency was getting worse and the evidence of congestive heart failure persisted. On the third day the patient then underwent embolization of feeding arteries with microcoils. The cardiac failure and thrombocytopenic coagulopathy had improved significantly without complications. We conclude that transcutaneous arterial embolization is an effective and safe treatment in this neonate and should be considered for the treatment of control high-output cardiac failure and coagulopathy in infants with hemangioma and kasabach-merritt syndrome.
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3/23. Ruptured giant intrathoracic lipoblastoma in a 4-month-old infant: CT and MR findings.

    BACKGROUND: We describe a 4-month-old infant with a ruptured intrathoracic lipoblastoma arising from the parietal pleura and associated with a pleural effusion. OBJECTIVE: The clinical presentation was rapidly evolving respiratory distress. The chest radiograph showed a large mass and a pleural effusion in the right thoracic cavity. CT demonstrated an inhomogeneous low-attenuation mass which was 7 cm in diameter and which showed areas of enhancement after intravenous contrast medium. MRI showed a fatty intrathoracic mass with intratumoral streaks and whorls, which were attributed to loose fibrovascular connective tissue on pathological examination. RESULTS: thoracotomy and pathological examination revealed a ruptured intrathoracic lipoblastoma arising from the parietal pleura. CONCLUSION: The pleural effusion might have suggested rupture of the tumour.
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4/23. Malignant melanoma in a burn scar.

    Cancers of various sorts are occasionally encountered in burn scars. These lesions are usually squamous cell carcinomas, and the burn scars are usually old. Very rarely, malignant melanoma is encountered. An 87-year-old nursing home patient who had been burned by a lightening strike at age 16 was evaluated. She had sustained a wound covering 2% or 3% of her body surface involving her neck and the upper portion of her anterior trunk that had required several grafts. A lesion was noted over the suprasternal notch approximately 3 months before admission. The biopsy was reported as malignant melanoma. She was subsequently treated by wide reexcision with an associated Z-plasty for neck release. Because of the patient's age and the presence of four areas of regional lymph nodes nearby into which metastasis might spread, no lymph node dissections were carried out. The specimen from the reexcision was reported as squamous cell carcinoma in situ, melanoma in situ, and multinucleated giant cell reaction, acute and chronic infiltrates. The wound margins were clear.
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5/23. Giant tumors of the chest: preoperative embolization and resection.

    Giant tumors of the chest are rare. These tumors comprise a spectrum of disease from benign lesions to highly aggressive malignant tumors with cells of origin in the pleura, pulmonary parenchyma, blood vessels, thymus, and connective tissues. We report four cases of giant tumors of the thorax treated with preoperative arterial embolization followed by complete surgical resection. Their diagnostic and treatment courses, imaging, and pathology are described.
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6/23. Intrathoracic extrapulmonary tumor mass: hemangiopericytoma.

    hemangiopericytoma is an uncommon mesenchymal tumor originating from pericytes. We describe the clinical and morphologic features in a case of intrathoracic extrapulmonary giant hemangiopericytoma. The tumor was radically removed, and the microscopy report was benign hemangiopericytoma. Because of the high risk of local recurrence, long-term follow-up is important in such patients.
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7/23. Prenatal and perinatal aspects of a giant fetal cervicothoracal lymphangioma.

    A massive cervicothoracal lymphangioma was diagnosed in a fetus at 25 weeks of gestation. On ultrasound study, the mass showed septated, cystic components and extended from the right submandibular region to the right anterolateral thoracic wall including the right axilla and right scapula. Close sonographic follow-up revealed an increase in the size of the lymphangioma without fetal hydrops. An interdisciplinary approach including a pediatric surgeon, neonatologist, perinatologist and anesthesiologist was chosen. Elective cesarean section under general anesthesia was planned at 37 0 weeks of gestation. Surgical correction of the lymphangioma was successfully performed on the 4th day of life. Possible differential diagnoses and the obstetrical management are presented.
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8/23. Giant chondromas arising from the ribs. A report of four cases.

    Chondromas may arise from the ribs but seldom grow to giant size. In a series of twenty-one cases, four giant tumours were encountered. Three were treated by excision without leaving a significant defect of the chest wall or impairment of respiration; the fourth was examined by biopsy. No evidence of malignant change was discovered in these four large tumours.
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9/23. Haemangioma with coagulopathy: sustained response to prednisone.

    Two cases of giant haemangioma with thrombocytopenia are described. A satisfactory and sustained response to prednisone was achieved in respect of both coagulation abnormalities and tumour size. It is proposed that prednisone is effective by enhancement of thrombosis and reduction of fibrinolysis within the tumour, thus promoting a natural form of resolution. It is suggested that prednisone therapy should be first-choice treatment of complicated haemangiomas.
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10/23. Desmoid tumour in thoracotomy scar 5 years after excision of a left giant atrial appendage aneurysm in female with a family history of Gardner's syndrome.

    A very large desmoid tumour extensively involving the chest wall and the left anterior abdominal wall is described in a patient with a family history of Gardner's syndrome. The desmoid arose at the site of a thoracotomy scar due to the removal of a large aneurysm of the left atrial appendage five years before. Both a plastic surgeon and a thoracic surgeon were required to remove the tumour. Aneurysmal dilatation of the left atrium is extremely rare and has not been reported in association with Gardner's syndrome before.
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