scholarly journals Primary seminoma arising in the posterior mediastinum: a diagnostic challenge

2021 ◽  
Author(s):  
Sara Parini ◽  
Paolo Spina ◽  
Esther Papalia ◽  
Renzo Boldorini ◽  
Michele Abruzzese ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Germ Cell Tumors ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Tracer Uptake ◽  
Pathology Report ◽  
Diagnostic Challenge ◽  
Complete Excision

Primary mediastinal germ cell tumors are a rare finding, and one third of them are seminomas. Seminomas are found in the anterior mediastinum, whereas they are extremely rare within the posterior compartment. Most clinicians would not consider a primary seminoma in the differential diagnosis of a posterior mediastinal mass, as only two cases have been reported in literature. Here we present the case of a 57-year-old male with a primary seminoma arising in the left posterior mediastinum. He was asymptomatic and the mass was an incidental finding. Positron emission tomography (PET) revealed a small area with an avid tracer uptake. Transthoracic needle aspiration led to a non-diagnostic result. Due to the strong suspect of malignancy, a surgical excision was chosen to obtain a diagnosis. He underwent complete excision, and pathology report demonstrated a mediastinal seminoma. Subsequent further staging did not reveal any other location of the disease. Given the complete excision of the primary tumor, active surveillance was the treatment of choice. The patient is free of disease 48 months after diagnosis.

scholarly journals Castleman’s Disease Presenting as a Parotid Mass in the Pediatric Population: A Report of 2 Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sean W. Delaney ◽  
Shengmei Zhou ◽  
Dennis Maceri
Keyword(s):  
Pediatric Population ◽  
Castleman’S Disease ◽  
Neck Region ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Castleman's Disease ◽  
Pathologic Examination ◽  
Diagnostic Challenge ◽  
Angiofollicular Lymph Node Hyperplasia ◽  
Complete Excision

Introduction. Angiofollicular lymph node hyperplasia (Castleman’s disease) is a nonmalignant lymphoproliferative disorder that generally involves the lymph nodes of young adults, most commonly in the mediastinum. Rarely, Castleman’s disease may present in the parotid gland. The disease can be further classified into unicentric or multicentric forms, with considerable differences in presentation, treatment, and prognosis.Case(s). We present cases of two pediatric patients, aged 7 and 11, who both presented with a slow-growing, painless parotid mass. In each case, the mass was excised via a superficial parotidectomy and the diagnosis made postoperatively upon further pathologic examination. At 6 months of follow-up, both had fully intact facial nerve function and no evidence of recurrence.Discussion. Castleman’s disease presents a diagnostic challenge in the head and neck region, as radiographic characteristics and fine needle aspiration results are often inconclusive. Definitive diagnosis requires surgical excision for pathologic examination. The unicentric form generally presents as a painless mass and can be successfully treated with complete excision. The multicentric form is associated with constitutional symptoms and its treatment remains controversial.Conclusion. Although rare, clinicians should be aware of both forms of Castleman’s disease when creating a differential diagnosis for parotid masses.

scholarly journals Nodular fasciitis of the parotid gland engulfing the facial nerve: a conservative approach

2019 ◽  
Vol 12 (10) ◽  
pp. e231203
Author(s):  
Stephen Bennett ◽  
Kristian Hutson ◽  
Olakunle Ajayi ◽  
Andreas Hilger
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Benign Lesion ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Nodular Fasciitis ◽  
Conservative Approach ◽  
Complete Excision ◽  
Diagnostic Uncertainty ◽  
Accepted Practice

Nodular fasciitis (NF) is a rapidly growing benign lesion rarely reported in the parotid gland. It shares cytological features with other benign and malignant parotid neoplasms and may be difficult to diagnose based on fine needle aspiration cytology alone. Given this diagnostic conundrum, surgical excision for histology is recommended to facilitate definitive diagnosis. A case with significant involvement of the facial nerve is described, which has not previously been reported in the literature. Despite features of potential malignancy, the decision was taken to biopsy the lesion and not proceed to complete excision in an attempt to reduce the risk of facial nerve injury. Expert opinion later diagnosed NF. Contrary to accepted practice, where diagnostic uncertainty remains around the malignant potential of a lesion, risks and benefits of complete excision versus a conservative approach should be carefully weighed especially when the facial nerve is involved and NF is a possible diagnosis.

scholarly journals PATTERNS OF MEDIASTINAL TUMORS

2016 ◽  
Vol 23 (02) ◽  
pp. 223-227
Author(s):  
Niaz Hussain Soomro ◽  
Dr. Ali Shan Shariff ◽  
Aneeqa Ahsan Zafar ◽  
Omar Ehtisham ◽  
Guzel Maxood ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Medical Records ◽  
Germ Cell Tumors ◽  
Descriptive Study ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Common Type ◽  
Mediastinal Tumors ◽  
Mediastinal Masses ◽  
Common Location

Objective: To review all the mediastinal tumors and cysts operated uponat Department of Thoracic Surgery, OICD, DUHS over a 2.5 year period. Study design:Retrospective descriptive study. Place and duration of study: Ojha Institute of Chest Diseases,Dow University of Health Sciences, Karachi, Pakistan from November 2012- April 2015. Materialand methods: 50 patients with mediastinal masses of either sex were included in the study.Tumors were categorized as arising from the anterior, middle and posterior mediastinum onthe basis of CT scan chest. Tumors were classified into various type based on the results ofhistopathology. Data was obtained from hospital medical records and proformas were filledfor each patient. Results: A total of 50 patients with mediastinal masses were seen at theDepartment of Thoracic Surgery, Ojha Institute of Chest Diseases between Nov 2012- April2015. There were 30 males and 20 females (ratio 1.5:1). Most of the patients were between 11-70 years of age, with mean age of 32 years. The most common location for mediastinal tumorswas found to be the anterior mediastinum which comprised of 40% of all tumors, followed byposterior (32%) and middle mediastinum respectively (28.0%). Shwanomma (18%) was themost common type of tumor observed, followed by lymphoma (12%) and germ cell tumors(10%). Conclusion: Mediastinal tumors are relatively uncommon in clinical setting. Thesetumors represent a group of heterogeneous masses present between two pleural cavities. Adefinitive early diagnosis is the key in management and prognosis of the patient.We present our5 year experience of patterns of mediastinal tumors.

scholarly journals Giant lipoma of breast-a diagnostic dilemma

2021 ◽  
Vol 8 (2) ◽  
pp. 752
Author(s):  
D. J. Balsarkar ◽  
Sachin A. Suryawanshi ◽  
Muna Shaikh ◽  
Sudhir Dhobale
Keyword(s):  
Phyllodes Tumor ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Left Breast ◽  
Normal Breast ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Common Benign Tumor ◽  
Complete Surgical Excision ◽  
Giant Lipoma

Lipoma is the most common benign tumor of adipose tissue. Giant lipoma of breast is very rare.Majority of them are small in size, slow growing and asymptomatic until they reach large size. Most patients seek medical advice due to asymmetry in the breast and due to fear of malignancy. Breast lipomas pose a diagnostic challenge due to similarity of their texture to normal breast parenchyma and make it difficult to distinguish from other common breast lesions. The clinical and radiographic identification of breast lipoma remains challenging. Complete surgical excision with the capsule is essential to prevent recurrence. Breast reconstruction may require, to prevent asymmetry following surgical excision of giant breast lipoma. High degree of clinical suspicion and histolopathological correlation will help in preopertaive diagnosis of this clinical condition. Here, we report a case 50- year -old woman with left breast lump which clinically, radiologically and on fine needle aspiration cytology was diagnosed as phyllodes tumor, but after surgical excision it was reported as breast lipoma on final histopathology.

scholarly journals Neonatal oral teratoma: A case report

2021 ◽  
Vol 10 ◽  
pp. 24
Author(s):  
Helle Moustapha ◽  
Oumarou Habou ◽  
Kadre Alio Kadre Ousmane ◽  
Mahamoud Omid Ali Ada ◽  
Inoussa Daouda Bako ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Germ Cells ◽  
Primordial Germ Cells ◽  
Germ Cell Tumors ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Upper Lip ◽  
Complete Excision ◽  
Case Presentation ◽  
Irregular Mass

Background: Teratomas of the oral cavity are rare and can pose danger to a patient's life in terms of obstruction to the aerodigestive tract. These are the germ cell tumors that arise from all three layers of primordial germ cells. Case Presentation: A 2-day-old female neonate presented with a mass protruding from the oral cavity since birth with no significant antenatal history. Examination revealed a large (8 cm), firm, and irregular mass protruding from the oral cavity extending up to the inner surface of the upper lip and onto the gums, associated with cleft palate. Complete excision of the mass was done and histopathology confirmed the diagnosis. There were no postoperative complications. Conclusion: Oral cavity teratoma is a rare tumor with a good prognosis especially in its mature form. Surgical excision with multidisciplinary collaboration is needed in order to avoid any complications.

PS01.090: LAPAROSCOPIC EXCISION OF A PARAESOPHAGEAL BRONCHOGENIC CYST IN A 9-YEAR-OLD MALE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 75-75
Author(s):  
Satoshi Makita
Keyword(s):  
Bronchogenic Cyst ◽  
Conflicts Of Interest ◽  
Incidental Finding ◽  
Retrospective Chart Review ◽  
Posterior Mediastinum ◽  
Esophageal Wall ◽  
Complete Excision ◽  
Weighted Image ◽  
Mediastinal Masses ◽  
Laparoscopic Excision

Abstract Background Bronchogenic cyst is a malformation of the ventral foregut. It is ofen asymptomatic and discovered as an incidental finding. In children, it comprises approximately 6% of all mediastinal masses. However, paraesophageal bronchogenic cyst is a rare and has been reported only three cases in children. We report a case of a 9-year-old male with an asymptomatic paraesophageal bronchogenic cyst. Methods Retrospective chart review. Results A 9-year-old male was detected to have retrocardiac mass lesion (2.7 × 1.9 × 1.2 cm), which was detected incidentally on an abdominal computed tomography done for acute appendicitis. No enhancement was noticed after contrast administration. Magnetic resonance imaging revealed a well-circumscribed cyst adjacent to the esophagus just above the hiatus. T1-weighted image showed a low intensity mass and the T2-weighted image showed a high intensity mass. Endoscopic ultrasonography examination of the esophagus demonstrated a cystic mass, with low-echo density. The echo also showed disruption of the fourth layer of the esophageal wall. With these findings, esophageal duplication was suspected. A laparoscopic operation was performed via 4 ports plus one puncture. 5mm laparoscope (30°angle) was inserted in the umbilical port, three 5mm trocars were placed and 3mm grasping forceps was inserted. The cyst was identified in the intra-abdominal esophageal part. Lesion removal was performed with a coagulator hook. A complete excision of the cyst was achieved without perforating of the esophagus. The postoperative courses was uneventful with home discharging on day six. The pathological diagnosis was a bronchogenic cyst because of finding a ciliated respiratory epithelium and cartilage and mucus-secreting glands. Conclusion Paraesophageal bronchogenic cyst is rare. However, it should be considered in the differential diagnoses for mediastinal masses at any age. Laparoscopy is a safe and effective method to deal with masses of posterior mediastinum even in children. Disclosure All authors have declared no conflicts of interest.

scholarly journals An Unusual Neck Mass: A Case of a Parathyroid Cyst and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Anand Goomany ◽  
Amy Rafferty ◽  
Ian Smith
Keyword(s):  
Imaging Techniques ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Review Of The Literature ◽  
Diagnostic Challenge ◽  
Anterior Neck ◽  
Cystic Fluid ◽  
Parathyroid Cyst ◽  
Parathyroid Cysts

Parathyroid cysts (PC) are an unusual cause of neck swellings. The majority are nonfunctioning and prove to be a diagnostic challenge given their nonspecific physical and radiological characteristics. This is compounded by their rare occurrence, leading them to be overlooked in the differential diagnosis of neck lumps. Imaging techniques fail to determine the origin of these lesions, but a preoperative diagnosis can be achieved by fine-needle aspiration and measurement of cystic fluid C-terminal parathyroid hormone levels. Treatment of nonfunctioning cysts remains controversial and includes needle aspiration, injection of sclerosant, or surgical excision. We present a case of a 44-year-old female presenting with an asymptomatic anterior neck swelling, diagnosed postoperatively as a parathyroid cyst.

scholarly journals Schwannoma Base of Tongue: Report of a Rare Case and Review of Literature

2013 ◽  
Vol 4 (3) ◽  
pp. 133-135 ◽  
Author(s):  
Hitendra Prakash Singh ◽  
SP Agarwal ◽  
Nidhi Verma ◽  
Madhukar Vashistha ◽  
Amit Chaddha ◽  
...  
Keyword(s):  
Rare Case ◽  
Neck Region ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Review Of Literature ◽  
Complete Excision ◽  
Base Of Tongue ◽  
Magnetic Resonance Imaging Mri ◽  
Needle Aspiration Cytology ◽  
Slow Growing

ABSTRACT Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Extracranially, 25% of all schwannomas are located in the head and neck region. The intraoral lesions show a predilection for the tongue, followed by the palate, buccal mucosa, lips and gingiva respectively. Among these, base of tongue schwannoma are extremely rare. Schwannomas involving the tongue base remain asymptomatic unless they attain appreciable size. Diagnostic investigations include ultrasound scanning, computed tomography, magnetic resonance imaging (MRI), and fine-needle aspiration cytology. MRI is superior to other imaging modalities for the examination of the base of the tongue. The definitive diagnosis is based on histopathology. Surgical excision or enucleation with preserve nerve function is the treatment of choice for this rare tumor. The most common approach for complete excision is transoral route for base of tongue schwannoma. Authors report a case of base of tongue schwannoma which was treated with surgery by transoral route. How to cite this article Singh HP, Kumar S, Verma N, Vashistha M, Chaddha A, Agarwal SP, Babu S. Schwannoma Base of Tongue: Report of a Rare Case and Review of Literature. Int J Head Neck Surg 2013;4(3):133-135.

scholarly journals Mediastinal Mature Teratoma Revealed by Empyema

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammed Raoufi ◽  
Laila Herrak ◽  
Anas Benali ◽  
Leila Achaachi ◽  
Mustapha El Ftouh ◽  
...  
Keyword(s):  
Chest Pain ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Left Lung ◽  
Needle Aspiration ◽  
Anterior Mediastinum ◽  
Cystic Tumor ◽  
Left Hemithorax ◽  
Adequate Treatment ◽  
Mediastinal Teratoma

Teratomas are germ cell tumors, manifested with a great variety of clinical features; the most common extragonadal site is the anterior mediastinum. In this case, we report the patient with a large mature mediastinal teratoma with several components of ectodermal and endothermal epithelium. A 24-year-old female patient presented with history of persistent chest pain and progressively aggravating dyspnea for the previous 3 months. A chest X-ray showed a large opacity of the entire left hemithorax. Transcutaneous needle aspiration revealed a purulent fluid. The tube thoracostomy was introduced and the effusion was evacuated. Some weeks later, patient was seen in emergency for persistent cough and lateral chest pain. CT scan revealed a mass of the left hemithorax. The mass showed heterogeneous density, without compressing mediastinum great vessels and left hilar structures. Lipase value was elevated in needle aspiration. The patient underwent a total resection of the mediastinum mass via a left posterolateral thoracotomy. Microscopy revealed a mature teratoma with cystic structures. The patient subsequently made a full recovery. This case provide benign mediastinal teratoma with total atelectasis of left lung and elevated lipase value in needle transcutaneous aspiration; this event is explained by pancreatic component in the cystic tumor. Total removal of the tumor is adequate treatment for this type of teratoma and the prognosis is excellent.

scholarly journals Computerized tomography of mediastinal tumors

2009 ◽  
Vol 56 (4) ◽  
pp. 69-75
Author(s):  
D.U. Nenezic ◽  
R. Stevic
Keyword(s):  
Computerized Tomography ◽  
Germ Cell Tumors ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Mediastinal Tumors ◽  
Neurogenic Tumors ◽  
Complex Anatomy ◽  
Common Causes ◽  
Additional Imaging ◽  
Pericardial Cysts

Tumors of the mediastinum represent a very heterogeneous group of primary and metastatic tumors. Most tumors of the mediastinum are detected on chest radiography, but for more precise view additional imaging methods are necessary. The most common causes of tumor mass in anterior mediastinum are thymoma, germ cell tumors, retrosternal goitre and Hodgkin's lymphoma. In the middle mediastinum most commonly tumors are congenital cysts, such as bronhogenic and pericardial cysts, and enlarged lymph nodes, while in the posterior mediastinum dominantly present neurogenic tumors. Complex anatomy of mediastinum infrequently makes difficulties in radiological diagnosis of these tumors. Computerized tomography (CT) is a radiological method of choice in the diagnosis of primary and / or secondary mediastinal lesions. Localization and structure of the tumor masses are very important for diagnosis. Knowledge of anatomy, with the standard topographic divisions on the anterior, middle and posterior mediastinum is necessary prerequisite for a valid CT diagnostic. Lesions in all parts of the mediastinum are systematically presented from the aspect of practical recommendations, with a view of the typical pathological findings.

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