Giant Intrathoracic Schwannoma: A Case Report

Savu, Cornel; Grigorie, Vasile; Melinte, Alexandru; Diaconu, Camelia Cristina; Iliescu, Laura; Dimitriu, Mihai; Bălescu, Irina; Bacalbaşa, Nicolae

doi:10.21873/invivo.12194

Cited by 13 publications

(25 citation statements)

References 31 publications

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“…Some authors consider that the most common primary pleural tumors are solitary pleural fibromas; however, leiomyoma must be included as an option during the differential diagnosis, even though it is a rare pathology (35). In fact, during the differential diagnosis other types of tumors should also be taken into consideration, such as neuromas, secondary lesions or other intrapleural tumoral masses (36,37). In our case, we chose a cautious intraoperative approach using a wide resection with oncological margins, as if we were removing a solitary pleural fibroma.…”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyoma of the Visceral Pleura: An Unexpected Occurrence

Savu

Melinte²,

Gibu³

et al. 2021

In Vivo

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Background/Aim: Leiomyoma is a rare benign tumor originating from smooth muscle fibres. In the respiratory tract, these tumors are rare and in the pleura, cases are exceptional, with only a few reported so far. This is the main reason we decided to present this case of primary leiomyoma of the visceral pleura. Case Report: We present a case of a 51-year-old asymptomatic patient who, during a routine medical examination using standard chest radiography, presented with a 3 by 2 cm homogenous mass in the right superior pulmonary area, tangent to the chest wall (same level with the 3 rd rib). Further investigation using computed tomography (CT) in the chest confirmed the presence of a 31/18 mm solid mass in the right upper lobe, in contact with the parietal pleura. Surgery was performed for two reasons: i) removal of the tumoral mass and ii) establishing a histopathological diagnosis. Intraoperatively, a well-defined, homogenous, ivory white non-infiltrating mass was discovered in the right upper lobe on the visceral pleura and in close proximity to the minor fissure. The mass was removed with negative surgical margins and was left with healthy tissue. Histopathological examination and immunohistochemistry came as a surprise, establishing our diagnosis of leiomyoma. Conclusion: Primitive pleural leiomyoma must remain a possibility when considering the differential diagnosis of pleural tumors. The main course of treatment is complete surgical resection. In our case, longterm follow up did not present any local recurrence.Leiomyoma is a tumor originating in smooth muscular fibres and can occur anywhere in the body where this cell type exists. Leiomyomas are part of the mesenchymal tumor category. Most often, these tumors are present in the uterus, esophagus and small intestine (1, 2). The first description of leiomyoma belongs to Wirshaw in 1854 (1) while Steinard reported the first case of pulmonary leiomyoma in 1939 in a patient that also presented with a uterine fibroma (3). In 1958, Kloepfer described the presence of hereditary leiomyomatosis (2). Other hereditary leiomyomatosis have since been described with multiple simultaneous locations (4); however, the presence in the respiratory tract of a leiomyoma is rare, representing 2% of benign tumors found in this region (5,6).Primary pulmonary leiomyoma was first described in 1907 as a standalone pathology (7), with the first case of pulmonary leiomyoma being reported by Forkel, in 1910 (8).

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Section: Discussionmentioning

confidence: 99%

Primary Leiomyoma of the Visceral Pleura: An Unexpected Occurrence

Savu

Melinte²,

Gibu³

et al. 2021

In Vivo

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“…A number of studies revealed that 16% of SCLC tumors and 10% of low-grade neuroendocrine subtypes lose their expression of neuroendocrine markers: ASCL1, NeuroD1 and NKx2-1. This loss of neuroendocrine expression results in major morphology modifications such as growth characteristics, with major clinical implications (53,54). Glucose transfer transporter 1 (GLUT-1) is a protein that helps in the process of glucose transport, found in increased levels in all types of neuroendocrine cancers, indicating an HG-LNET (10).…”

Section: Biological Landscape Of Lung Neuroendocrine Tumors (Lnets)mentioning

confidence: 99%

Lung neuroendocrine tumors: A systematic literature review (Review)

et al. 2021

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Neuroendocrine tumors (NETs) can have multiple localizations in the human body however, most often, it appears in the in thorax at tracheobronchial tree and the thymus. NETs are a group of tumors with heterogenous malignancy that evolve from neuroendocrine cells, with the lung being the second target organ after the gastrointestinal tract. These rare tumors are usually asymptomatic and non-functional with little information regarding incidence in the specialty literature. The main purpose of this review, was the analysis of the available literature in all aspects while mainly focusing on molecular diagnosis data and secondly, by using this molecular landscape to establish a differentiation of lung neuroendocrine tumors (LNETs). By analyzing the literature, new data were revealed regarding histological evaluation, genetic aberrations, prognosis depending on the type of LNET and therapeutic options that derive from these. Efficient management of these tumors is essential in the handling of symptoms and increase in life expectancy, especially in patients with functional tumors. Histological differentiation of LNETs is important in establishing proper therapeutic options and prognosis. Combined types of LNETs remain a controversial topic of discussion regarding diagnosis and treatment, a topic on which further studies are required in order to improve diagnosis in this group of tumors with heterogenous malignancy. Contents1. Introduction 2. Materials and methods 3. Epidemiology 4. Classification 5. Precursor lesions 6. Clinical features 7. Tumor staging 8. Biological landscape of lung neuroendocrine tumors (LNETs) 9. Radiological diagnosis 10. Surgical treatment 11. Advanced LNETs therapy 12. Conclusions

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“…Due to compression or invasion of the surrounding tissues, neurogenic symptoms, back pain, or difficulty swallowing can also be observed ( 7 , 13 ). Apically located mediastinal masses may cause superior vena cava syndrome due to the compression ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Giant tumors of the posterior mediastinum: a narrative review of surgical treatment

Demiröz¹,

Sayan²,

Çelik³

2022

Mediastinum

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Background and Objective The posterior mediastinum is a potential space along the paravertebral sulci or between the posterior aspect of the pericardium and the vertebrae. This compartment is classically the most frequent location site of neurogenic tumors. Whereas neurofibroma and schwannoma are neurogenic tumors that commonly arise from peripheral nerves, sympathetic nerves are the origin of ganglioneuroma, neuroblastoma, ganglioneuroblastoma, and neuroectodermal cells closely associated with autonomic nerves are the origin of paragangliomas and pheochromocytomas. Additionally, tumors from the esophagus, tumors of mesenchymal origin, lymphoma, ectopic goiter, and diseases with lymph node hyperplasia may also settle on this compartment. The objectives are to identify term “giant posterior mediastinal tumor” and the etiology, clinical features, diagnostic methods, pathological types, surgical methods applied, and technical details of these methods for the treatment of these tumors. Methods In this review, the term “giant tumor” was used to define tumors larger than 10 cm settled in the posterior mediastinum. PubMed database was searched with keywords “posterior mediastinum, giant mass” or “posterior mediastinum, tumor, giant” limited to English language and full-text available studies published between years 1984–2021. Key Content and Findings As a result of the literature review with the relevant terms, 23 case reports were found in accordance with the inclusion criteria. We detected the most common giant posterior mediastinum tumors were neurogenic origin (schwannoma, ganglioneuroma, ganglioneuroblastoma, triton tumor) in that review. The most common surgical approach was posterolateral thoracotomy. Treatment response to surgical total excision was good in most of cases. Conclusions The definitive diagnosis and treatment of giant posterior mediastinal tumors is made by surgical excision. Diagnostic procedures and subsequent surgical planning may vary depending on the origin and localization. Adjuvant treatment and follow-up should be conducted on the histopathological features.

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Giant Intrathoracic Schwannoma: A Case Report

Cited by 13 publications

References 31 publications

Primary Leiomyoma of the Visceral Pleura: An Unexpected Occurrence

Primary Leiomyoma of the Visceral Pleura: An Unexpected Occurrence

Lung neuroendocrine tumors: A systematic literature review (Review)

Giant tumors of the posterior mediastinum: a narrative review of surgical treatment

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