Visceral Mediastinal Primary Nerve Sheath Tumor Located near the Right Brachiocephalic Vein

• Omura Akiisa

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Watari Hirokazu

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Sakata Ryuhei

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Kawagishi Sachi

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Tanaka Ryo

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Kimura Toru

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Maniwa Tomohiro

  Department of General Thoracic Surgery, Osaka International Cancer Institute

• Honma Keiichiro

  Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute

• Okami Jiro

  Department of General Thoracic Surgery, Osaka International Cancer Institute

Bibliographic Information

Other Title

• 右腕頭静脈近傍に認めた中縦隔原発malignant peripheral nerve sheath tumorの1切除例

Abstract

Background. Malignant peripheral nerve sheath tumor (MPNST) is an uncommon malignant schwannoma, and some rare cases of MPNST in the mediastinum have been reported. Case. The patient was a woman in her 60s. An abnormal shadow was incidentally detected on chest X-ray, and the patient was referred to our institution. The tumor was located in the area between the right upper lobe of the lung and the right brachiocephalic vein, with a diameter of 53 mm, and positron emission tomography-computed tomography (PET-CT) showed a fluorodeoxyglucose (FDG) uptake with a maximum standardized uptake value of 32.9 in the tumor. A transbronchial biopsy was performed. A pathological examination of the biopsy specimen showed no evidence of an epithelial tumor. We diagnosed the patient with a malignant tumor suspected to be MPNST or lung sarcoma. We decided to perform surgery. We resected the tumor via open thoracotomy. Due to the involvement of the right phrenic nerve, the right phrenic nerve was resected. The permanent pathological specimen showed dense proliferation of spindle cells with atypical mitoses, and immunohistochemistry was weakly positive for S100 and positive for SOX10. The pathological diagnosis was MPNST of mediastinal origin. The postoperative course was uneventful. The patient was alive without recurrence at one year after surgery. Conclusion. We experienced a case of resection of an MPNST of visceral mediastinal primary origin. In cases where a tumor suspected of being an MPNST on a preoperative examination is adjacent to a great vessel, thorough preoperative preparation, including vessel replacement with synthetic graft, should be performed to ensure complete resection of the tumor.

Journal

• Haigan

  Haigan 62 (1), 44-49, 2022-02-20

  The Japan Lung Cancer Society

Keywords

• Mediastinal tumor
• Malignant peripheral nerve sheath tumor

Details

• CRID: 1390854139455168768
• NII Article ID: 130008163799
• DOI: 10.2482/haigan.62.44
• ISSN: 13489992
• ISSN: 03869628
• Web Site: https://www.jstage.jst.go.jp/article/haigan/62/1/62_44/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022210935
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed