Um caso raro de tumores torácicos malignos sincrônicos

Abstract

uncommon and include functioning paragangliomas (pheochromocytomas) and nonsecreting chemodectomas.(1)Of all of the neurogenic mediastinal tumors, 40-65% originate from the peripheral nerve sheath. Schwannomas (neurilemmomas) and neurofibromas, both benign lesions, account for over 95% of the tumors in this group. Malignant peripheral nerve sheath tumors (malignant schwannomas) are extremely aggressive and account for the remaining 2-4%. Case reportA 61-year-old male patient sought treatment in the emergency room of our institution reporting subscapular pain for two months. The IntroductionNeurogenic tumors are the most common mediastinal tumors, accounting for 20-35% of all of the mediastinal neoplasms.(1,2) Neurogenic tumors are also responsible for approximately 75% of all lesions in the posterior mediastinum, although they are typically benign and asymptomatic. When symptoms are present, they should raise the suspicion of a malignant lesion. AbstractMalignant neurogenic mediastinal tumors in adults are uncommon and extremely aggressive. We report the case of a 61-year-old male patient with the simultaneous occurrence of malignant mediastinal schwannoma and bronchioloalveolar carcinoma. Although bronchioloalveolar carcinoma is present in 4-7% of the resected synchronous thoracic tumors, this association has never been reported in the literature. However, it is a common finding in patients presenting apparently inflammatory infiltrates and ground-glass opacities, as in the case presented here.

Tumor maligno da bainha do nervo periférico (TMBNP): relato de caso.

“…Sua apresentação clínica é bastante variável, normalmente afetam mais raízes nervosas, como plexo braquial e sacral, retroperitoneal, cabeça, pescoço, tronco e membros, podendo ou não estar associada a sintomas neurológicos, como parestesia e fraqueza muscular. Devido ao seu crescimento acelerado, infiltra partes vizinhas e produz metástases para pulmões, ossos e/ou fígado 1,3,4 .…”

Lung cancer and schwannoma - the pitfalls of positron emission tomography

“…In general, schwannomas are well defined and asymptomatic, being diagnosed incidentally, usually after the age of 30 years. ( 3 , 4 ) Given that schwannomas show variable 18F-fluorodeoxyglucose (FDG) uptake, with the SUV ranging from 1.9 to 12.0, PET has limited utility in distinguishing between schwannomas and malignant peripheral nerve sheath tumors. ( 5 ) In many cases, it is impossible to distinguish between a schwannoma and a malignant tumor before biopsy or surgery precisely because schwannomas can show high FDG uptake.…”

“…Apresentam-se, em geral, bem delimitados e assintomáticos, sendo diagnosticados incidentalmente, geralmente após os 30 anos de idade. ( 3 , 4 ) Como a absorção de 18F-fluordesoxiglicose (FDG) pelos schwannomas é variável, com SUV variando de 1,9 a 12,0, a PET possui uma limitação importante na distinção entre o schwannoma e as neoplasias malignas da bainha de nervos periféricos. ( 5 ) É justamente devido a essa possibilidade de captação de altos valores de FDG que, muitas vezes, o schwannoma não pode ser distinguido de um tumor maligno antes da biópsia ou cirurgia.…”