1/700. Papillary endothelial hyperplasia presenting as a chest wall neoplasm. Soft tissue hematomas generally resolve but may persist and develop into slow-growing, organized masses. These chronic expanding hematomas are characterized by a pseudocapsule and a predominantly necrotic central cavity, with foci of newly formed capillaries. These have been called chronic expanding hematomas or Masson's papillary endothelial hyperplasia. These lesions can mimic vascular neoplasms and must be considered in the evaluation of expanding soft tissue vascular malformations. ( info) |
2/700. A large intrathoracic parathyroid adenoma. A case is described in which an unusually large parathyroid adenoma was visible on the plain chest radiograph taken during the investigation of hypercalcaemia. This was diagnosed preoperatively and a scheme is suggested whereby such a disgnosis can now readily be made. The differential diagnosis is discussed ant the literature is reviewed. ( info) |
3/700. Prenatal sonographic features of embryonal rhabdomyosarcoma. We describe a case of fetal rhabdomyosarcoma detected during the third trimester of pregnancy by prenatal sonography. At 33 weeks' gestation, sonography performed because of suspected polyhydramnios showed a solid mass of 120 x 54 mm arising from the anterior wall of the fetal thoracic cage. Another mass within the left maxillary area which originated from the left orbital floor was also detected. In the abdomen, there were multiple round masses in and around the liver. As the previous scan at 28 weeks had appeared normal, the multiple masses which became visible and enlarged rapidly in different locations led us to believe that there was fetal cancer. The most likely diagnosis was rhabdomyosarcoma (which was later confirmed), because it is the most prevalent soft-tissue tumor in children and may develop within or outside muscle anywhere in the body and at any age. Two other reported cases which were detected by prenatal ultrasound examination are also discussed. ( info) |
4/700. A novel EWS-ERG rearrangement generating two hybrid mRNAs in a peripheral primitive neuroectodermal tumour (pPNET) with a t(15;22) translocation. The occurrence of a t(15;22) translocation in a peripheral primitive neuroectodermal tumour (pPNET) has been previously reported. Molecular examination revealed the presence in tumour mRNA of two hybrid transcripts containing the 5' portion of the EWS gene fused to the 3' portion of the ERG gene. Sequence analyses indicated that both aberrant mRNAs most likely originated from the same rearrangement, which produced different hybrid isoforms due to the presence of an alternatively spliced exon in the ERG gene. To the authors' knowledge, this is the first report of the detection of two hybrid EWS-ERG mRNAs within the same tumour. ( info) |
5/700. Angiosarcoma of the chest wall. Angiosarcoma is a rare and highly malignant tumor of vascular origin. The causative factors include trauma, radiation, foreign bodies, thorium dioxide, and viral infections. We report a case of angiosarcoma occurring in a thoracotomy incision 17 years after operation for stage I lung cancer. ( info) |
6/700. Surgical resection combined with intrathoracic hyperthermic perfusion for thymic carcinoma with an intrathoracic disseminated lesion: a case report. Thymic undifferentiated carcinoma has a poor prognosis. We encountered a patient with thymic carcinoma associated with an intrathoracic disseminated lesion, who underwent surgery combined with intrathoracic hyperthermic perfusion after systemic chemotherapy and showed good results. The 45-year-old man was diagnosed as having a thymoma with an intrathoracic disseminated lesion. After he underwent three courses of systemic chemotherapy, he was admitted to our hospital. An anterior mediastinal tumor and an intrathoracic disseminated lesion remained, and were treated by surgical resection combined with intrathoracic hyperthermic perfusion. The tumors were histopathologically diagnosed as thymic undifferentiated carcinomas with pleural dissemination. At present, approximately 16 months after surgery, the patient is alive without recurrence. ( info) |
7/700. Spinal cord vascular injuries following surgery of advanced thoracic neuroblastoma: an unusual catastrophic complication. BACKGROUND: Spinal cord injury is a possible complication associated with removal of thoracic dumbbell neuroblastomas. Our experience with two children whose postsurgical course was complicated by midthoracic spinal cord ischemia is reported there. Permanent paraplegia resulted in both. PROCEDURE AND RESULTS: Preoperative awareness of the origin and distribution of the Adamkiewicz artery (arteria radiculomedullaris magna, ARMM) and of the possible collateral pathways for spinal cord blood supply may be helpful in the planning of operations that involve dissection in the midthoracic posterior mediastinum. Otherwise, a flaccid paraplegia may result. CONCLUSIONS: The syndrome is presumed to be triggered by a spasm, an embolism, or a iatrogenic interruption of the ARMM. ( info) |
8/700. cat-scratch disease simulating a malignant process of the chest wall. cat-scratch disease is a well-known cause of regional adenopathy in immunocompetent children. Rarely, patients may present with symptoms simulating a neoplastic disease. The case of a 12-year-old boy with fever, swelling of the chest wall and hepatosplenic nodules is reported. Histological analysis of biopsy specimen obtained from the chest wall lesion and the liver revealed granulomatous reaction without malignant cells. Serological investigations were positive for bartonella species. The symptoms and the lesions disappeared after oral antibiotic therapy (ciprofloxacin) was started. The patient remained symptom-free 12 months later. CONCLUSION: The present case emphasizes the wide spectrum of clinical manifestations associated with cat-scratch disease which should be investigated as differential diagnosis of manifestations suggesting a neoplastic disease in children. ( info) |
9/700. Fine needle aspiration of thoracic splenosis. A case report. BACKGROUND: Thoracic splenosis is a rare event, and fine needle aspiration (FNA) of a pleural implant of splenic tissue can be a pitfall when previous anamnestic data are ignored. CASE: A 53-year-old male underwent FNA of a left thoracic subpleural nodule highly suggestive of a metastatic lesion. The presence of a population of small and medium-sized lymphocytes suggested the possibility of lymphoproliferative disease; frozen sections confirmed this possibility. The final diagnosis was normal splenic tissue. Twenty-five years earlier the patient sustained a gunshot wound in the left side of the upper abdomen followed by splenectomy and drainage of the left pleural cavity because of mild, concomitant hemothorax. CONCLUSION: A left pleural thoracic nodule in subjects with a previous history of traumatic rupture of the spleen must be considered highly suggestive of thoracic splenosis. Scintigraphy with Tc 99 m and magnetic resonance imaging are diagnostic, while FNA, especially in the absence of anamnestic data, can create a pitfall that can induce inappropriate removal of ectopic, normally functioning splenic tissue. ( info) |
10/700. Comparison of kilovoltage x-ray and electron beam dose distributions for radiotherapy of the sternum. The dose distributions for a patient with cancer involving the sternum were calculated for both a kilovoltage x-ray beam and a megavoltage electron beam. The minimum target dose and dose uniformity over the target volume were significantly better using electrons (90%-101%) than kilovoltage x-rays (68%-119%). The calculated lung dose and integral patient dose were also less for electrons than kilovoltage x-rays. For treating cancers of the sternum with radical intent, megavoltage electrons are recommended as the treatment mode of choice rather than kilovoltage x-rays. ( info) |