Background Neurogenic tumors of the mediastinum are rare tumors located mainly in the posterior mediastinum. The aim of this study was to report a single-institution experience of these tumors. Methods This study was conducted between 2005 and 2017. Bivariate analysis was performed to assess correlations between the cellularity, mitotic index, presence of a capsule, and potential for malignancy of peripheral nerve sheath tumors. Results There were 86 patients enrolled in the study. The mean age was 42.51 years. Nineteen patients were asymptomatic and their tumors were discovered incidentally. Microscopic diagnosis confirmed a schwannoma in 45 cases, neurofibroma in 12, malignant peripheral nerve sheath tumor in 9, ganglioneuroma in 14, ganglioneuroblastoma in 4, and neuroblastoma in 2. Bivariate analysis showed a significant correlation between the absence of a capsule, the degree of atypia, a high mitotic index, and high cellularity with the potential for malignancy ( p < 0.05). Surgical resection was the main treatment modality in 84 cases. The mean survival was estimated to be 51.309 months. The log-rank test showed a significant difference in survival according to histologic subtype and between benign and malignant tumors ( p < 0.0001). Conclusion Even if radiologic means are helpful in suggesting the diagnosis, a positive diagnosis of neurogenic tumors is based on microscopic features. High mitotic activity and cellularity, and severe cytonuclear atypia are the features most suggestive of malignancy.
Although it is considered to be a benign lesion, this tumor can be locally very aggressive, and has a high local recurrence rate depending upon the efficacy of surgical resection.
This combined treatment of pulmonary and hepatic hydatid cysts by the left-sided thoracic approach is feasible and provides a good outcome. It should be indicated under the same conditions of accessibility and feasibility applied for the right thoracic side.
Objectives:
Primary cardiac tumors are rare and account for 0.001 to 0.03% of cardiac
lesions. The authors aim to describe the clinical, the microscopic and the therapeutic characteristics
of these tumors through a 13-year-experience in order to highlight the diagnostic challenges faced.
Methods:
We report 10 primary cardiac tumors diagnosed in the Departments of Pathology and
Thoracic Surgery of the same hospital through a 13-year-period.
Results:
Our study was conducted on 7 women and 3 men. The mean age of the patients was 54.22
years (average, 12 to 79 years). Dyspnea represented the most frequent symptom. Physical
examination was normal in all patients. Trans-thoracic ultra-sound examination was performed in all
patients. Cardiac MRI allowed localizing the tumors in 2 patients. They were located into the left
auricle (6 cases), the right auricle (1 case) and the pericardium (3 cases). The microscopic
examination was concluded to myxoma (7 cases), haemangioma (2 cases) and
hemangioendothelioma (1 case). Surgical resection was possible in 9 patients. It was impossible in
the case of hemangioendothelioma because of the adherence. One death was recorded secondary to
postoperative arrhythmia. The other patients presented no complications after a follow-up period
ranging from 2 months to 5 years.
Conclusion:
Cardiac tumors are challenging in their diagnosis and management. A positive
diagnosis is based on microscopic examination. Surgical treatment plays a key role and is possible in
the majority of benign tumors. The prognosis of malignant tumors remains poor even if a complete
surgical resection is possible.
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