Well-differentiated Adenocarcinoma Arising from Mature Cystic Teratoma of the Mediastinum (Teratoma with Malignant Transformation):<i>Report of a Surgical Case</i>

Morinaga, Soichiro; Nomori, Hiroaki; Kobayashi, R; Atsumi, Yoshihito

doi:10.1093/ajcp/101.4.531

Cited by 71 publications

(56 citation statements)

References 9 publications

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“…(11) In 1994, there was a case of well-differentiated adenocarcinoma arising from a mature cystic teratoma of the mediastinum. (12) In the case reported here, a primary carcinoid tumor was found to have arisen within the teratoma. Such evolution is extremely rare, and there have only three such cases have been published in journals indexed for the Latin American and Caribbean Health Sciences Literature database or for Medline.…”

Section: Discussionmentioning

confidence: 61%

Teratoma de mediastino com degeneração maligna

Squeff¹,

Gerace²,

Júnior³

et al. 2008

J. bras. pneumol.

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slowly progressing anterior mediastinal teratoma. This is an extremely rare case, not only in terms of the presence of this type of tumor in an elderly patient but also in terms of its evolution to malignancy. This, together with the fact that, in the literature, we have found only three studies of carcinoid tumors arising within mediastinal teratomas, has motivated us to write this article. Case reportA 66-year-old male patient, born in the city of São Luiz (in the state of Maranhão) and a resident of the city of São Paulo (in the state of São Paulo), was admitted to IntroductionTeratomas are germ cell tumors originating from the three embryonic germ layers. These tumors can be found at multiple sites, and most are benign. They are the second most common tumors of the anterior mediastinum, after thymomas, and are most often seen in young adults.(1) They account for 8 to 13% of all tumors occurring in this region. If they are treated surgically, the prognosis is quite favorable. Although there is little data in the literature regarding the evolution of a teratoma to malignancy, it is known to be an extremely rare occurrence. (2,3) We report the case of a 66-year-old patient submitted to resection of a carcinoid tumor (revealed by anatomopathological examination) that had arisen within a AbstractHere, we report the case of a patient with a slowly-progressing anterior mediastinal teratoma submitted to surgical resection. The anatomopathological examination of the sample revealed malignant degeneration to carcinoid tumor. Such evolution is very rare, and we have found only three related studies in the literature. We describe the clinicopathological features of the tumor and discuss the treatment administered. The evolution was satisfactory, and the patient was submitted to oncological treatment.Keywords: Mediastinal neoplasms; Teratoma; Carcinoid tumor; Mediastinum/surgery. ResumoNo presente artigo, relatamos o caso de um paciente portador de teratoma de mediastino anterior, de evolução lenta, o qual foi submetido à ressecção cirúrgica. O exame anatomopatológico da peça revelou degeneração maligna para tumor carcinóide. Tal evolução é extremamente rara, sendo encontrados na literatura apenas três artigos correlatos. Apresentamos uma descrição clínico-patológica do tumor e, por fim, discutimos a conduta terapêutica. Houve evolução satisfatória, e o paciente foi submetido a tratamento oncológico.Descritores: Neoplasias do mediastino; Teratoma; Tumor carcinóide; Mediastino/cirurgia.

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Section: Discussionmentioning

confidence: 61%

Teratoma de mediastino com degeneração maligna

Squeff¹,

Gerace²,

Júnior³

et al. 2008

J. bras. pneumol.

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“…[4][5][6] To the best of our knowledge, no naturally occurring TMT of the mediastinum has previously been reported in a child. This case suggests that malignant transformation can occur naturally in a child and that the tumor can grow over a short period.…”

Section: Discussionmentioning

confidence: 92%

“…7) Complete surgical resection is the most important prognostic factor, and the postoperative prognosis is good if the tumor has not extended beyond the capsule. 4) Chemotherapy should be adapted to the malignant components. However, the malignant components are generally refractory to chemotherapy, and embryonal rhabdomyosarcomas tend to be particularly unresponsive to chemotherapy regimens.…”

Section: Discussionmentioning

confidence: 99%

Teratoma with Naturally Occurring Malignant Transformation in a Child

Takahashi

Okumura

Matsuoka

et al. 2011

ATCS

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We present a 12-year-old girl with a teratoma with malignant transformation (TMT) of the mediastinum. Computed tomography showed a cystic mass (5.0 cm × 4.0 cm) with a thick solid portion, in the anterior mediastinum. Six months later, the solid portion of the mass had enlarged, and surgical resection was performed. The resected tumor was 7.0 × 5.0 × 4.0 cm in size. The cystic portion was a mature teratoma, and the solid portion predominantly comprised a viable embryonal rhabdomyosarcoma. There were no immature teratomatous elements or other germ-cell components. The histopathologic diagnosis was a mature teratoma with embryonal rhabdomyosarcoma, a so-called TMT. The tumor recurred, despite adjuvant chemotherapy. The patient died of progressive disease 16 months postoperatively. To the best of our knowledge, no naturally occurring TMT of the mediastinum has previously been reported in a child. Surgical resection at an early stage is necessary. Keywords: mediastinal teratoma, malignant transformationAnn Thorac Cardiovasc Surg 2011; 17: 588-590 doi: 10.5761/atcs.cr.11.01658In a review of the literature, Moran and Suster reported that mediastinal mature teratomas with rhabdomyosarcomas accounted for only four of 322 germ-cell tumors in the mediastinum.3) However, the precise incidence of mediastinal TMT is not known. We present a rare case of mediastinal TMT and a literature review. Case ReportThe patient was a 12-year-old girl who presented with a mediastinal mass. The mass was accidentally found during a medical checkup. She was initially referred to the department of pediatrics of our hospital. Her history was unremarkable. A computed tomography (CT) scan revealed a lobulated cystic mass with a thick solid portion, in the anterior mediastinum.The mass measured 5.0 cm × 4.0 cm (Fig. 1A). The wall of the solid portion was not well defined. There was no associated pleural effusion or mediastinal lymph node enlargement.Tumor markers, including serum alpha-fetoprotein and human chorionic gonadotropin, were within normal limits. No distant metastases were detected by whole-body

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“…In some patients, particularly if elderly, cells in the teratoma spontaneously become malignant. In other patients, particularly younger ones, the malignant transformation may be triggered by administration of chemotherapy or radiotherapy [10].…”

Section: Discussionmentioning

confidence: 99%