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At least 109 records · Page 6Linked to original sources

Clear cell sarcoma arising from the chest wall: a case report.

Clear cell sarcoma is a rare malignant soft tissue neoplasm that usually arises adjacent to tendons or aponeuroses. The clinical course is rather slow, with repeated local recurrences followed by late metastases and eventual death. The principal sites of this neoplasm are the extremities, but tumors do occur in the trunk on rare occasions. We report a case of clear cell sarcoma arising from the chest wall. The patient, a 20-year-old woman, had noticed a chest wall mass and pain for 2 years. Biopsy of the mass showed abundant nests of round cells with clear cytoplasm. On immunohistochemical examination, tumor cells were strongly immunoreactive for S-100 and HMB-45. A diagnosis of clear cell sarcoma was confirmed. There was no other lesion found in the patient through routine imaging studies. She was treated with two courses of chemotherapy using ifosfamide, carboplatin, and etoposide. Subsequently, the tumor, including adjacent tissue, the chest wall, and sternum, was resected with a wide margin; and the defect of the chest wall was covered with Marlex mesh fabric, regin, and a musculocutaneous flap. She has shown no symptoms or signs of recurrence during 2 years of follow-up.

Adult↗

Spontaneous hemothorax caused by a chest wall chondrosarcoma.

A 48-year-old man who presented with chest pain was found to have a spontaneous hemothorax caused by a large grade II chondrosarcoma. This was diagnosed on the basis of the findings from thoracotomy. After chest tube drainage of the hemothorax, the tissue obtained by two computed tomography-guided biopsies of a residual mass did not yield findings that allowed diagnosis of the tumor. This unusual case illustrates the importance of a systematic workup whenever a spontaneous hemothorax is encountered.

Bone Neoplasms↗

Combined post-chemotherapy retroperitoneal lymph node dissection and resection of chest tumor under the same anesthetic is appropriate based on morbidity and tumor pathology.

PURPOSE: We determine if post-chemotherapy resection of residual retroperitoneal and chest tumor under the same anesthetic is reasonable based on tumor pathology and morbidity, and if the finding of necrosis in the abdomen allows observation of chest tumor. MATERIALS AND METHODS: We retrospectively reviewed 143 post-chemotherapy patients who underwent resection of residual retroperitoneal and chest disease under the same anesthetic. RESULTS: Retroperitoneal pathology was generally predictive of chest pathology. Concordance existed in 77.5% of patients with necrosis, 70% with teratoma and 69% with cancer of the abdomen. However, the correlation was much stronger (86%) in predicting necrosis/fibrosis if cases were categorized as uncomplicated by Indiana University criteria. Although the morbidity of the combined approach is higher than that of standard post-chemotherapy retroperitoneal lymph node dissection, it was acceptable. CONCLUSIONS: The morbidity of post-chemotherapy retroperitoneal lymph node dissection and resection of chest disease under the same anesthetic is acceptable. Retroperitoneal pathology generally predicts chest pathology but this correlation is much stronger if the case is uncomplicated based on our criteria. In an uncomplicated case the discovery of necrosis of the abdomen allows observation of chest tumor.

Anesthesia↗

Bilateral elastofibroma dorsi: proper positioning for an accurate diagnosis.

Elastofibroma dorsi is a rare, slow-growing, ill-defined soft tissue tumor of the chest wall, most commonly located beneath the rhomboid major and latissimus dorsi muscles. It is usually unilateral, and bilateral involvement occurs in only 10% of patients. We report herein a case of a 56-year-old woman with bilateral elastofibroma dorsi. The patient was found to have bilateral involvement of the tumor following a physical examination with proper positioning. An elastofibroma should be considered in the differential diagnosis of tumors deeply located at the periscapular area. Meticulous physical examination may reveal a nonpalpable coexisting tumor with deep subscapular location and help the accurate diagnosis of bilateral elastofibroma dorsi, hence preventing a secondary operation.

Female↗

Chest wall tumors presenting as breast lumps.

Two recently seen patients presenting with large breast lumps that proved to be pure mesenchymal tumors arising from the underlying chest wall are presented. One tumor proved to be a giant cell tumor of soft tissue and the other an osteogenic sarcoma. It is suggested that these two cases may not be unique and that some mesenchymal breast tumors might have their origin in the chest wall. Breast computed tomography (CT) scans would help identify similar cases.

Aged↗

Granulomatous mycosis fungoides with extensive chest wall involvement.

A 40-year-old woman presented with a 5-year history of a mass overlying her right pectoralis major muscle. Histopathology of the lesion revealed a florid granulomatous infiltrate including an atypical lymphocytic component with marked epidermotropism consistent with granulomatous mycosis fungoides. Staging investigations demonstrated the tumour to be localized to the right chest. Consequently, the patient was treated with radiotherapy (50 Gy) to the lesion with good clinical effect. However, she soon developed a clinically palpable lesion on the left chest outside the radiotherapy field. Positron emission tomography scanning demonstrated an extensive left-sided chest wall tumour and also residual tumour on the right. This left-sided lesion failed to respond to systemic chemotherapy. Further radiotherapy (50 Gy) has recently been administered to the left chest lesion; the response is being monitored. While granulomatous inflammation has been previously described in cutaneous T-cell lymphomas, it is rare and is often associated with a delay in the diagnosis and difficulty with clinical staging. The clinical presentation can be extremely variable and consequently, diagnosis rests with histological features, immunohistochemical studies and gene rearrangement analysis.

Adult↗

Cytogenetic characteristics of a malignant rhabdoid tumor arising from the paravertebral region. A case report.

The pathological and cytogenetic features of an extrarenal malignant rhabdoid tumor (MRT) arising from the paravertebral region in an infant were investigated. The patient died 4 months after diagnosis, due to aggressive tumor progression. The tumor was composed of medium-sized round cells with cytoplasm containing eosinophilic inclusions, which ultrastructurally were composed of densely packed whorled intermediate filaments. Flow-cytometric analysis of the tumor cells revealed a diploid pattern. Amplification of the N-myc oncogene was not identified. Immunohistologically, the inclusion bodies showed a positive reaction with antiserum against vimentin. The tumor cells were not reactive with antiserum against epithelial membrane antigen, anti-keratin (polyclonal) or cytokeratin (monoclonal, CK1), but did react with 5H10, an antiserum established from human sarcomatous Wilms' tumor. This case is discussed with reference to the literature on extrarenal MRT, placing stress on the histogenesis of this tumor.

Female↗

Chemodectoma of the orbit.

The histological and clinical features of a primary chemodectoma arising in the orbit are described. It is suggested that the tumour may have arisen from chemoreceptor tissue in the area of the lacrimal gland.

Aged↗

Chest wall tumors: radiologic findings and pathologic correlation: part 1. Benign tumors.

Benign chest wall tumors are uncommon lesions that originate from blood vessels, nerves, bone, cartilage, or fat. Chest radiography is an important technique for evaluation of such tumors, especially those that originate from bone, because it can depict mineralization and thus indicate the diagnosis. Computed tomography (CT) and magnetic resonance (MR) imaging are helpful in further delineating the location and extent of the tumor and in identifying tumor tissues and types. Although the radiologic manifestations of benign and malignant chest wall tumors frequently overlap, differences in characteristic location and appearance occasionally allow a differential diagnosis to be made with confidence. Such features include the presence of mature fat tissue with little or no septation (lipoma), the presence of phleboliths and characteristic vascular enhancement (cavernous hemangioma), evidence of neural origin combined with a targetlike appearance on MR images (neurofibroma), well-defined continuity of cortical and medullary bone with the site of origin (osteochondroma), or fusiform expansion and ground-glass matrix (fibrous dysplasia). Both aneurysmal bone cysts and giant cell tumors typically manifest as expansile osteolytic lesions and occasionally show fluid-fluid levels suggestive of diagnosis.

Adult↗

Chest wall tumors: radiologic findings and pathologic correlation: part 2. Malignant tumors.

Malignant chest wall tumors are classified into eight main diagnostic categories: muscular, vascular, fibrous and fibrohistiocytic, peripheral nerve, osseous and cartilaginous, adipose, hematologic, and cutaneous. However, there are malignant tumors that arise in the chest wall and that do not fit well in any of these categories (eg, Ewing sarcoma and synovial sarcoma). Malignant chest wall tumors typically manifest as painful, rapidly growing, large palpable masses. Chest radiography, the technique most often used for initial evaluation, can be helpful for detecting cortical destruction. However, computed tomography is more sensitive than chest radiography for detecting calcified tumor matrix and cortical destruction. Magnetic resonance imaging often allows more accurate delineation and localization of the tumor and is helpful for determining the presence and extent of tumor invasion and for tissue characterization. Although the imaging features of many malignant chest wall tumors are nonspecific, knowledge of the typical radiologic manifestations of these tumors often enables their differentiation from benign chest wall tumors and occasionally allows a specific diagnosis to be suggested. The article reviews the clinical and imaging features of the most common malignant chest wall tumors and presents images collected at a single cancer referral center.

Adult↗

Soft tissue tumours and mass-like lesions of the chest wall: a pictorial review of CT and MR findings.

Soft tissue tumours and tumour-like lesions of the chest wall are uncommon. The purpose of this pictorial essay is to describe the imaging findings of chest wall soft tissue tumours and tumour-like lesions. We searched the radiological and pathological archive at our institution retrospectively and reviewed the literature on soft tissue tumours of the chest wall. Common chest wall soft tissue tumours and mass-like lesions include peripheral nerve tumours, lipomas, liposarcomas, haemangiomas, elastofibromas, metastases, lymphoma and abscesses. Other lesions encountered include desmoid tumours and malignant fibrous histiocytoma. Many have distinctive radiological findings or occur in specific locations, allowing a specific radiological diagnosis to be suggested.

Adult↗