Pediatric thoracic mass lesions: Beyond the common

Abstract

Thoracic mass lesions can be categorized as originating in one of the three major compartments: a) chest wall and pleura, b) lung parenchyma and airways, c) mediastinum. While some of these, such as lymphoma, are common in both children and adults, others are rare and unique to childhood. The goal of this review is to familiarize radiologists with unusual but distinctive mass lesions of the pediatric thorax.

Persistent spontaneous pneumothorax as a primary manifestation of primary synovial sarcoma of the lung: a case report

“…Its presence constitutes a specific marker of SS and can be detected by FISH or molecular biology techniques, such as RT-PCR. [11][12][13] As mentioned in our clinical case, our patient had positive findings in the immunolabeling techniques and the molecular chromosomal study.…”

“…On HRCT of the chest, it is seen as a mass with heterogeneous enhancement and well-delimited borders, without bone involvement or calcifications inside. 11 Less frequently, PPSS presents as persistent or recurrent pneumothorax due to rupture of a cystic or bullous pulmonary lesion, as evidenced by the clinical case reported here. Such lesion characteristics warrant a differential diagnosis with benign cysts, type 1 pleuropulmonary blastoma, mesenchymal cystic hamartoma, and lymphangioleiomyomatosis.…”

“…The first-line treatment is surgical resection associated with chemotherapy, radiotherapy or both, as indicated in our patient, based on tumor staging. 7,11 The overall 5-year survival of adolescent patients with localized SS exceeds 80%; however, in the case of PPSS, this figure decreases to 30%. 14,15 Axial location, difficult complete resection, large size (> 5 cm), and the presence of metastasis are poor prognostic factors for PPSS.…”

Neumotórax espontáneo persistente como manifestación primaria de sarcoma sinovial pleuropulmonar primario: a propósito de un caso

“…En la TACAR de tórax, como masa con realce heterogéneo y bordes bien delimitados, sin afectación ósea ni calcificaciones en su interior. 11 De forma menos frecuente, el SSPP se presenta como neumotórax persistente o recidivante debido a la ruptura de una lesión pulmonar de tipo quística o bullosa, como lo evidencia el caso clínico expuesto. Dichas características de la lesión ameritan realizar el diagnóstico diferencial con quistes benignos, blastoma pleuropulmonar tipo 1, hamartoma quístico mesenquimal y linfangioleiomiomatosis.…”

“…En más del 90 % de los casos, presentan una translocación entre el cromosoma X y el 18: t(X;18) (p11.2;q11.2), que resulta en la fusión del gen SYT del cromosoma 18 y los genes SSX1 o SSX2 en el cromosoma X. Su presencia constituye un marcador específico de SS y puede detectarse con la prueba de FISH o técnicas de biología molecular como RT-PCR. [11][12][13] Como se mencionó en el caso clínico, el paciente evidenció hallazgos positivos en las técnicas de inmunomarcación y en el estudio cromosómico molecular.…”