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Case Series
Two surgical cases of juvenile posterior mediastinal tumors with difficulty in preoperative diagnosis
1 Assistant Professor, Department of Thoracic Surgery, National Defense Medical College, Saitama 359-8513, Japan
2 Lecturer, Department of Thoracic Surgery, National Defense Medical College, Saitama 359-8513, Japan
3 Resident, Department of Thoracic Surgery, National Defense Medical College, Saitama 359-8513, Japan
4 Professor, Department of Thoracic Surgery, National Defense Medical College, Saitama 359-8513, Japan
5 Director, Department of Thoracic Surgery, Tokorozawa-Meisei Hospital, Saitama, Japan
Address correspondence to:
Kazuyuki Komori
Department of Thoracic Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513,
Japan
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Article ID: 101236Z01KK2021
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Komori K, Hashimoto H, Yoshikawa K, Kameda K, Taguchi S, Ozeki Y. Two surgical cases of juvenile posterior mediastinal tumors with difficulty in preoperative diagnosis. Int J Case Rep Images 2021;12:101236Z01KK2021.ABSTRACT
Introduction: Mediastinal tumors develop in specific locations. Neurogenic tumors appear most frequently in cases of posterior mediastinal tumors, followed by teratomas or benign tumors. Here, we have described two surgically treated cases of juvenile posterior malignant tumors with similar clinical courses of tumor growing and difficulty in preoperative diagnosis.
Case Series: Case 1: A 32-year-old woman presented to our hospital with a right posterior mediastinal tumor detected during a medical checkup on computed tomography. Positron emission tomography-computed tomography and magnetic resonance imaging showed a neurogenic tumor. Tumor resection was performed via video-assisted thoracic surgery for the retrospectively evident growth. Pathological examination revealed a solitary fibrous tumor with immunohistochemical findings (vimentin/B-cell lymphoma 2 protein/STAT6 positivity). The patient was recurrence free at 72 months postoperatively. Case 2: A 32-year-old woman presented to our hospital with a chest abnormality revealed on medical examination. Computed tomography showed that the right posterior mediastinal tumor was a neurogenic tumor. Evident growth on radiograph and abnormal fluorodeoxyglucose accumulations in the spleen and tumor on positron emission tomography-computed tomography were observed; hence, video-assisted thoracic surgery biopsy was performed to differentiate malignant lymphoma. A solitary fibrous tumor was suspected on immunohistochemical examination; the biopsy findings revealed B-cell lymphoma 2 protein/CD34 positivity and vimentin negativity. Subsequently, tumor resection was performed using video-assisted thoracic surgery. Final examination revealed chondrosarcoma based on immunohistochemical findings (CD99/B-cell lymphoma 2 protein positivity and CD34 negativity). The patient was recurrence free at 66 months postoperatively.
Conclusion: Solitary fibrous tumors and chondrosarcomas should be considered in the differential diagnosis of posterior mediastinal tumors. Their diagnosis is difficult for clinical courses, operative findings or even biopsy, and made only on histopathological findings after resection.
Keywords: Chondrosarcoma, Posterior mediastinal tumor, Solitary fibrous tumor, Surgery
SUPPORTING INFORMATION
Acknowledgments
We would like to thank Hideyuki Shimazaki and Susumu Matsukuma for their advice on the pathological findings, and Editage (www.editage.com) for English language editing.
Author ContributionsKazuyuki Komori - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Hiroshi Hashimoto - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kotaro Yoshikawa - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Koji Kameda - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Shinichi Taguchi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Yuichi Ozeki - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Kazuyuki Komori et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
