Successful Removal of a Primitive Neuroectodermal Tumor in the Lung with Gross Extension into the Left Atrium

H, Yokouchi; Kodama, Kazunori; Higashiyama, Masaaki; Takami, Kouji; Kobayashi, Tuyoshi; Takami, Hideki; Nakamura, Sumio; Horai, Takeshi

doi:10.1055/s-2007-1013156

Cited by 3 publications

(3 citation statements)

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“…Pulmonary EFT prognosis is poor. In reported studies, about half of the patients died of their disease 1–54 months (median, 11 months; n = 18) after diagnosis . Radical surgical resection at early stages with multiagent chemotherapy would more likely obtain a better outcome .…”

Section: Discussionmentioning

confidence: 99%

Cytopathological findings of primary pulmonary Ewing family of tumors with EWSR1 translocation: A case report

et al. 2016

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Primary pulmonary neoplasms of the Ewing family of tumors (EFT) are extremely rare and usually occur in adolescents or young adults. Only about 40 cases of pulmonary EFT have been reported in English literature, and no cytological studies have been documented. In this report, we describe the cytopathological findings of a primary pulmonary EFT in an elderly patient. A 70‐year‐old man sought care because of a progressing cough and dyspnea. Chest computed tomography revealed a circumscribed mass of 6 cm in the left upper lobe. Fine needle aspiration cytology and core needle biopsy revealed uniform round cell proliferation. The predominant population consisted of cells with thickened nuclear membranes, finely dispersed chromatin, single distinct nucleoli, and indistinct cytoplasm. The other population consisted of smaller cells with darker chromatin. The cytoplasm stained positive for periodic acid–Schiff stain and was digested by diastase. Immunohistochemistry showed positivity for MIC2 (CD99), and focal positivity for neuron specific enolase, synaptophysin, and chromogranin A. Fluorescence in situ hybridization (FISH) revealed EWSR1 translocation. Although rare, pulmonary EFT cannot be disregarded, regardless of age. When two populations of uniform, round cells are observed, immunohistochemistry with MIC2 (CD99) and cytogenetic analysis by reverse transcription polymerase chain reaction or FISH should be considered. Cytological diagnosis may play an important role in the early diagnosis and treatment of pulmonary EFT.

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Section: Discussionmentioning

confidence: 99%

Cytopathological findings of primary pulmonary Ewing family of tumors with EWSR1 translocation: A case report

et al. 2016

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“…To the best of our knowledge, there have only been 18 cases published in the English literature over the last two decades. In these 18 cases, squamous cell carcinoma was the most common pathological type and was present in 5 cases (7,9-12), followed by 4 neuroendocrine carcinoma cases (13-16), 3 adenocarcinoma cases (1,17,18), 3 sarcoma cases (5,6,19), 1 large cell carcinoma case (20) and 1 neuroectodermal tumor case (21). The pathology of a further case was reported as sarcoma mixed with squamous carcinoma (16); although histopathological examination demonstrated that the primary tumor was poorly-differentiated, the cardiac and intravascular portions of each tumor were less differentiated and more necrotic than the primary focus in the lung (3).…”

Section: Discussionmentioning

confidence: 99%

“…Improved dose-delivery techniques also increase the utility of radiation (1,25). The 18 previous cases (1,(5)(6)(7)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) show that surgery combined with chemotherapy is the most common treatment for this condition, however, prognosis remains extremely poor, with overall survival times ranging between 4 and 17 months. In the present case, surgery was not advised due to the presence of distant metastasis and the high risk of the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic radiotherapy for the treatment of lung cancer with a giant left atrial tumor thrombus: A case report and literature review

Lou

Qiu

et al. 2016

Oncology Letters

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Abstract. Lung cancer presenting with a giant atrial tumor thrombus is particularly rare. Surgical resection, aided by a cardiopulmonary bypass, is the standard treatment of choice if there is no distant metastasis. However, this form of surgery carries a high risk, with the subsequent patient prognosis being extremely poor. The current study describes the case of a 52-year-old man presenting with left lung squamous cell carcinoma that had extended into the left atrium. The patient was treated with stereotactic radiotherapy, and regarding the atrial disease, a complete response was achieved within 12 months. The present case demonstrates that stereotactic radiotherapy may be a beneficial palliative treatment for patients with stage IV lung cancer invading the left atrium. IntroductionAdvanced non-small cell lung cancer with associated atrial involvement is uncommon, occurring in ~10% of patients presenting with bronchogenic carcinoma (1,2). Patients with the disease usually possess circulatory and respiratory symptoms, and coughing, hemoptysis, dyspnea, weight loss and an extremely poor performance status are the typical associated features (3). Furthermore, an associated intra-atrial tumor thrombus is particularly rare, with tumor thrombi potentially leading to widespread systemic embolization and/or outflow tract obstruction (4-6). As a result, treatment is always warranted. If there is no presentation of distant metastasis, surgical resection is considered as the gold-standard therapy. However, chemotherapy may also be administered. Cases of non-small cell lung cancer with associated intra-atrial tumor thrombi are usually diagnosed using enhanced computed tomography (CT).Due to the rarity of this condition, incidence and mortality rates remain unknown, however, patient prognosis is extremely poor with an overall survival time of 4-17 months (1,7). The present study reports the case of a patient with stage IV lung cancer with invasion into the left atrium, for which a complete response was achieved following treatment with stereotactic radiotherapy. Case reportIn April 2012, a 52-year-old man was admitted to the Center of Radiation Oncology, Wujing Hospital (Shanghai, China) presenting with a 3-month history of progressive dyspnea and coughing. The patient also had a history of hypertension and smoking. An enhanced CT scan (Optima CT660 FREEdom; GE Healthcare, Piscataway, NJ, USA) revealed a left hilar tumor wrapped around the left pulmonary artery and vein, along with a large mass in the left atrium (Fig. 1A). A transbronchial biopsy was performed. Subsequently, tissue was formalin-fixed (Shanghai Ziyi Reagent Factory, Shanghai, China) paraffin-embedded (Leica Microsystems, Ltd., Milton Keynes, UK) and cut into 4 µm sections for hematoxylin and eosin (Baso Diagnostics Inc., Zhuhai, China) staining and immunohistochemistry. The biopsy revealed that the primary site was consistent with nests and trabecula of carcinoma cells proliferating with necrotic debris and intercellular bridges structures ( Fig. 2A and B)...

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Surgical management of thoracic malignancies invading the heart or great vessels

Park

Bacchetta

Bains

et al. 2004

The Annals of Thoracic Surgery

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Successful Removal of a Primitive Neuroectodermal Tumor in the Lung with Gross Extension into the Left Atrium

Cited by 3 publications

References 0 publications

Cytopathological findings of primary pulmonary Ewing family of tumors with EWSR1 translocation: A case report

Cytopathological findings of primary pulmonary Ewing family of tumors with EWSR1 translocation: A case report

Stereotactic radiotherapy for the treatment of lung cancer with a giant left atrial tumor thrombus: A case report and literature review

Surgical management of thoracic malignancies invading the heart or great vessels

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