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Mediastinal tumours

Karin Gasser
A 10-year-old female Australian Cattle Dog was referred for investigation of a mediastinal mass. During clinical examination, a mandarin- sized mass was detected ventrally of the trachea. According to computed tomographic (CT) findings and cytology of a fine-needle aspirate, thyroid neoplasia was suspected. The assumed tumour affected the left thyroid gland and was staged as stadium II because of enlargement of the ipsilateral cervical and retropharyngeal lymph nodes. The left thyroid, including the parathyroid gland, was removed surgically with a guarded prognosis...
February 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
Prudence Dy, Cristina Lajom, Josephino Sanchez
Neurogenic tumours of the mediastinum in adults occur most often at the posterior mediastinum, majority of which are benign of nerve sheath in origin. A 72-year-old woman, known asthmatic, presented with chronic symptoms of hoarseness, dysphagia, chest heaviness, easy fatigability, cough, epigastric pain, feeling of abdominal fullness and choking with food intake and at a supine position. Treated for other disorders, routine chest X-ray incidentally found a homogenous convex radiodensity at the right paratracheal area; mass which was also observed with CT and 18F-fludeoxyglucose-positron emission tomography/CT scan studies...
March 13, 2018: BMJ Case Reports
Constantin Ciuce, Răzvan Scurtu, Cătălin Ciuce, Raluca Apostu, Horea Bocşe, George Dindelegan
Introduction: Neoplastic invasion of the structures of the cervical region originating from a malignant tumour developed in one of the viscera of the throat may benefit from cervical exenteration. Defined as resection of the hypopharynx, cervical oesophagus, larynx and cervical trachea, exenteration has limited indications and is mandatorily accompanied by digestive tube reconstruction. The aim of this article is to highlight the indication, surgical strategy and important surgical stages illustrated by images from personal professional experience...
January 2018: Chirurgia
Shih-Peng Liu, Hung-Che Chien, Chun-Ku Chen, Chih-Cheng Hsieh, Chien-Sheng Huang
We report the case of a 77-year-old woman presenting with out-of-hospital cardiac arrest, which was then interpreted as an acute, life-threatening critical airway compression by a huge mediastinal tumour without appropriate diagnosis. Emergency extracorporeal membrane oxygenation was cannulated for sufficient respiratory support after spontaneous circulation was regained. After the multidisciplinary team, involving thoracic surgeons, discussed the resectability of the mediastinal tumour, the patient underwent successful resection of the mediastinal tumour through a median sternotomy...
April 2018: Respirology Case Reports
Herbert Decaluwé, Johnny Moons, Steffen Fieuws, Walter De Wever, Christophe Deroose, Alessia Stanzi, Lieven Depypere, Kristiaan Nackaerts, Johan Coolen, Maarten Lambrecht, Eric Verbeken, Dirk De Ruysscher, Johan Vansteenkiste, Dirk Van Raemdonck, Paul De Leyn, Christophe Dooms
OBJECTIVES: Current guidelines recommend preoperative invasive mediastinal staging in centrally located tumours with negative mediastinum on positron emission tomography-computed tomography, based on a 20-30% prevalence of occult mediastinal disease (pN2-3). However, a uniform definition of central tumour location is lacking. Our objective was to determine the best definition in predicting occult pN2-3. METHODS: A single-institution database was queried for patients with (suspected) non-small-cell lung cancer staged cN0 after positron emission tomography-computed tomography and referred to invasive staging and/or primary surgery...
February 13, 2018: European Journal of Cardio-thoracic Surgery
Georgios K Prezerakos, Parag Sayal, Antonios Kourliouros, Periclis Pericleous, George Ladas, Adrian Casey
PURPOSE: Cervicothoracic paravertebral neoplasms extending into the mediastinum pose a surgical challenge due the complex regional anatomy, their biological nature, rarity and surgeon's unfamiliarity with the region. We aim to define a surgical access framework addressing the aforementioned complexities whilst achieving oncological clearance. METHODS: We carried out a retrospective review of 28 consecutive patients operated in two tertiary referral centres between 1998 and 2015...
February 14, 2018: European Spine Journal
Shipra Verma, Justin Chan, Chong Chew, Christopher Schultz
BACKGROUND: Lung cancers managed surgically with curative intent are sometimes upstaged postoperatively. The potential contributions from surgical waiting time and primary tumour 18F-FDG avidity on positron emission tomography (PET)/computed tomography (CT) are unknown. METHODS: We reviewed the records of 153 Royal Adelaide Hospital surgical patients with primary lung cancers from 2013 to 2016 who had preoperative staging combining CT, 18F-FDG PET/CT and biopsy...
January 31, 2018: Heart, Lung & Circulation
Anton Dzian, Fúčela Ivan, Huťka Zdenko, Szépe Peter
Synchronous multiple primary lung cancer (SMPLC) means tumours present at the same time, which are separate and have different histology. We present the case of a 66-year-old patient with a combination of small-cell lung carcinoma (SCLC) with adenocarcinoma in the same lobe with metastasis of SCLC in the mediastinal lymph node. This is a rare case. We performed a standard left upper video-assisted thoracoscopic lobectomy with mediastinal lymphadenectomy and adjuvant therapy targeted to SCLC was administered...
December 14, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Chris Harrington, Lyn Smith, Jennifer Bisland, Elisabet López González, Neil Jamieson, Stuart Paterson, Adrian John Stanley
AIM: To investigate the impact of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and positron emission tomography-computed tomography (PET-CT) in the nodal staging of upper gastrointestinal (GI) cancer in a tertiary referral centre. METHODS: We performed a retrospective review of prospectively recorded data held on all patients with a diagnosis of upper GI cancer made between January 2009 and December 2015. Only those patients who had both a PET-CT and EUS with FNA sampling of a mediastinal node distant from the primary tumour were included...
January 16, 2018: World Journal of Gastrointestinal Endoscopy
Ayşe Çiğdem Tütüncü, Pınar Kendigelen, Güner Kaya
Mediastinal masses are benign or malignant tumours that originate from the thymus, thyroid, lung, lymphoid system, pleura, or pericardium. Cardiovascular and respiratory symptoms may occur because of the compression of surrounding tissues along with growing mass. In this study, we present the anaesthetic management of a 6-month-old child having a massive anterior mediastinal mass that had a compressing effect.
December 2017: Turkish Journal of Anaesthesiology and Reanimation
Garrett M Harp, Gregory N Matwiyoff, Steven J Escobar, Keith E Thompson, Addie Alkhas, Alfredo R Ramirez
Mediastinal lesions occur in a wide variety of clinical conditions. Metastatic granulosa cell tumour (GCT) in the mediastinum is a rare occurrence. We report a case of a woman who had a metastatic (GCT) in her mediastinum 40 years after treatment of the initial neoplasm. Surgical resection of the mediastinal mass revealed a low-grade epithelioid neoplasm with coffee bean-shaped nuclei and immunohistochemical stains that were consistent with metastatic GCT.
February 2018: Respirology Case Reports
G S Chowdhary, Malav Jhala
Tumours may produce growth factors and cytokines responsible for signs and symptoms distant to the primary or metastatic site. This may be the first sign of a malignancy and its recognition may be critical for early cancer detection. Moreover, proper diagnosis spares the patient of extensive and expensive search for an alternate cause of the neurological dysfunction. In neurological paraneoplastic syndromes like Lambert Eaton Myasthenic syndrome associated with small cell lung cancer, evidence of autoimmunity against presynaptic neuro-muscular junction by anti voltage gated calcium channel anti bodies is well documented...
September 2017: Journal of the Association of Physicians of India
T Araki, L M Sholl, H Hatabu, M Nishino
AIM: To investigate the clinical and image features of thymic neuroendocrine tumours (NETs), and characterise the radiological patterns of recurrence and metastasis on serial imaging studies. MATERIALS AND METHODS: The study included 14 patients (11 males) with a histopathological diagnosis of thymic NETs (one typical carcinoid, eight atypical carcinoid, and five large cell neuroendocrine carcinoma). Preoperative images were assessed for features of primary tumours...
January 5, 2018: Clinical Radiology
Nadia Junqueira, Ricardo Ferreira, André Sena, Ângelo Nobre
INTRODUCTION: The treatment of choice for mediastinal tumours is surgical, with the standard approach being sternotomy. Because of the invasive nature of this procedure, the management of these masses through mini-invasive surgery has become an alternative method. PRESENTATION OF CASE: We report the case of a woman with a mediastinum tumour and a new technique used for resection, through an inframammary left incision, using a Thoratrak rib spreader and Rultract Skyhook retractor assisted by a video...
December 7, 2017: International Journal of Surgery Case Reports
Ramona Erber, Robert Stöhr, Stefanie Herlein, Claudia Giedl, Ralf Joachim Rieker, Florian Fuchs, Joachim H Ficker, Arndt Hartmann, Elke Veltrup, Ralph M Wirtz, Wolfgang M Brueckl
BACKGROUND: Immunohistochemical (IHC) assessment of programmed death-ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC) has become important since the development of anti-PD-1/-PD-L1 directed drugs. Various PD-L1 antibodies and cut-offs have been used in different trials to predict response to these drugs, thus comparison of those studies is difficult. We compared PD-L1 mRNA expression measured by RT-qPCR with PD-L1 protein expression evaluated by IHC. Moreover, we investigated the impact of different tumour tissue acquisition methods on the reliability of PD-L1 measurement techniques...
December 2017: Anticancer Research
H L Weaver, S D Preston, H H Wong, P Jani, A S Coonar
A 73-year-old man was referred for surgical excision of a massive mediastinal and cervical liposarcoma following neoadjuvant chemotherapy. Surgery was performed via a cervical incision, sternotomy and right posterolateral thoracotomy. The tumour arose from the oesophagus, which underwent extensive dissection and was oversewn with pleura after tumour resection. Histology confirmed a completely excised grade 2 de-differentiated liposarcoma with complete macroscopic excision. The patient made an excellent recovery...
February 2018: Annals of the Royal College of Surgeons of England
Mathieu Charest, Josephine Pressacco, Jaramie Thomas-Gittens
A 25 year old female with known neurofibromatosis type 1 with a large anterior mediastinal mass was investigated. F18-FDG PET-CT revealed a radiotracer avid anterior mediastinal mass with SUVmax of 4.3 and demonstrating a hypoactive center. The Iodine-123 MIBG SPECT-CT study performed subsequently did not demonstrate any uptake, thereby excluding for the most part the diagnoses of paraganglioma or neuroblastoma. At final pathology, a malignant peripheral nerve sheath tumour (MPNST) of the pericardium with areas of chondrosarcomatous and angiosarcomatous differentiation was diagnosed...
November 10, 2017: Journal of Nuclear Medicine Technology
P Serra, J Sanz-Santos, E Castellà, B Cirauqui, F Andreo, M Llatjós, M Avila, M Margelí, L Serrano, C Centeno, V Quiroga, M Torky, J Ruiz-Manzano
BACKGROUND: In breast cancer patients, the expression statuses of oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are crucial in the choice of treatment. Receptor expression in metastatic lesions can differ from the primary tumour. The aim of our study was to analyse the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to obtain samples allowing the identification of ER, PR and HER2 expression in patients with mediastinal metastases of breast cancer...
November 9, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
Antoine Legras, Hélène Roussel, Giuseppe Mangiameli, Alex Arame, Bertrand Grand, Ciprian Pricopi, Alain Badia, Laure Gibault, Cécile Badoual, Elizabeth Fabre, Pierre Laurent-Puig, Hélène Blons, Françoise Le Pimpec-Barthes
Mutational heterogeneity could explain different metastatic patterns among IIIA-N2 lung cancer and influence prognosis. The identification of subclonal mutations using deep sequencing to evaluate the degree of molecular heterogeneity may improve IIIA-N2 classification. The aim of this prospective study was to assess mutational and immunohistochemical characteristics in primary tumours and involved lymph nodes (LN) in operated patients. Four patients operated for primary lung carcinoma and unisite N2 mediastinal involvement were consecutively selected...
November 6, 2017: Pathology Oncology Research: POR
Isabelle Moneke, Jussuf T Kaifi, Raphael Kloeser, Patrick Samson, Benedikt Haager, Sebastian Wiesemann, Sven Diederichs, Bernward Passlick
OBJECTIVES: Distant metastasis arising from thyroid cancer is rare but has been associated with significantly reduced long-term survival, especially when refractory to radioactive iodine ablation. We provide one of the largest studies worldwide reporting the outcome after salvage pulmonary metastasectomy for this entity, aiming to identify prognostic factors and to analyse surgical indication. METHODS: We retrospectively analysed the medical records of 43 patients who had undergone pulmonary metastasectomy for radioactive iodine-refractory thyroid cancer from 1985 to 2016...
October 30, 2017: European Journal of Cardio-thoracic Surgery
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