Video‐assisted thoracoscopic surgery can help enable the complete resection of a mediastinal tumor caused by immunoglobulin G4‐related disease and avoid the need for postoperative medication: A case report

Uchida, Tsuyoshi; Matsubara, Hirochika; Nagasaka, Satoshi; Kina, Satsuki; Ichihara, Tomofumi; Matsuoka, Hiroyasu; Nakajima, Hiroyuki

doi:10.1111/ases.12450

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…IgG4-RD cases with single-organ involvement, such as the present case, are rare, with only one case of IgG4-RD occurring in the mediastinum previously reported [2]. Tissue sampling is necessary to diagnose IgG4-RD, and thus, a surgical biopsy was inevitable in this case.…”

Section: Discussionmentioning

confidence: 72%

“…Immunoglobulin G4-related disease (IgG4-RD), a systemic autoimmune disease, is characterized by enlarged, massive, and thickened lesions in various body organs, laboratory ndings of high serum IgG4 concentrations, marked lymphocytic and IgG4-positive plasma in ltration, and brosis of the tissues [1]. It affects nearly every organ, and its clinical course varies, depending on the involved organ; however, few reports exist on its occurrence in the mediastinum [2]. In rare cases, when the mediastinum is involved, the diagnosis is di cult.…”

Section: Introductionmentioning

confidence: 99%

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Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with immunoglobulin G4- related disease: a case report

Takeuchi

Takizawa

Hosokawa

et al. 2023

Preprint

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Background: Immunoglobulin (Ig)G4-related disease affects nearly every organ, and its clinical course varies depending on the involved organ; however, its occurrence in the mediastinum is rarely reported. Case presentation: A 58-year-old woman presented with a posterior mediastinal tumor along the thoracic spine on imaging. Based on her elevated serum IgG4 level of 349.7 mg/dL, IgG4-related disease was suspected. Since the tumor was growing and malignancy could not be excluded, surgical resection was performed for definitive diagnosis. Robot-assisted thoracoscopic surgery was performed via the left semipronation and right thoracic approaches. The irregularly-shaped tumor was located on the level of the seventh to ninth thoracic vertebra, along the sympathetic nerve. A malignancy was not excluded based on the appearance of the tumor. The tumor had poor mobility. The sympathetic nerves, intercostal arteries, and veins were also excised. In this case, the articulated forceps, used during the robotic surgery, were useful in achieving complete tumor resection along the vertebral body. The pathological examination revealed IgG4-positive plasma infiltration, which fulfilled the criteria for IgG4-related diseases. The postoperative course was uneventful, and the patient underwent follow-up on an outpatient basis without additional medications. Conclusion: The clinical presentation of IgG4-related disease varies, based on the involved organs. This case was rare because the mediastinum was involved, and it emphasized the effectiveness of surgical resection.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with immunoglobulin G4- related disease: a case report

Takeuchi

Takizawa

Hosokawa

et al. 2023

Preprint

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show abstract

“…Four cases of IgG4-RD occurring exclusively in the posterior mediastinum have been reported in previous literature (Table 1 ). In all cases, percutaneous biopsy was difficult, and in two cases, resection was performed as the intraoperative rapid pathological examination did not rule out malignancy [ 3 , 4 ]. Likewise, in two cases, biopsy was performed only for diagnostic purposes [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with immunoglobulin G4-related disease: a case report

Takeuchi,

Takizawa,

Bando

et al. 2024

J Cardiothorac Surg

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Background Immunoglobulin (Ig)G4-related disease affects nearly every organ, and its clinical course varies depending on the involved organ; however, its occurrence in the mediastinum is rarely reported. Case presentation A 58-year-old woman presented with a posterior mediastinal tumor along the thoracic spine on imaging. Based on her elevated serum IgG4 level of 349.7 mg/dL, IgG4-related disease was suspected. Since the tumor was growing and malignancy could not be excluded, surgical resection was performed for definitive diagnosis. Robot-assisted thoracoscopic surgery was performed via the left semipronation and right thoracic approaches. The irregularly-shaped tumor was located on the level of the seventh to ninth thoracic vertebra, along the sympathetic nerve. A malignancy was not excluded based on the appearance of the tumor. The tumor had poor mobility. The sympathetic nerves, intercostal arteries, and veins were also excised. In this case, the articulated forceps, used during the robotic surgery, were useful in achieving complete tumor resection along the vertebral body. The pathological examination revealed IgG4-positive plasma infiltration, which fulfilled the criteria for IgG4-related diseases. The postoperative course was uneventful, and the patient underwent follow-up on an outpatient basis without additional medications. Conclusion The clinical presentation of IgG4-related disease varies, based on the involved organs. This case was rare because the mediastinum was involved, and it emphasized the effectiveness of surgical resection.

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“…Gopalsamy et al (11) reported that the inhibition of IL-1β and IL-6 expression effectively inhibits the pain stress response. In the study of different operation methods for mediastinal tumor resection, Uchida et al (23) and Kamata et al (24) found that VATS is the first choice for tumor resection. In the present study, a judgement of pain stress indicators was added in the confirmation of results, which enhanced the real-time control of operation.…”

Section: Discussionmentioning

confidence: 99%

Effect of video‑assisted thoracoscopic surgery on pain stress indicators NO, IL‑1β and IL‑6 in the treatment of mediastinal tumor in children

et al. 2020

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This study aimed to investigate the effect of video-assisted thoracoscopic surgery (VATS) on pain stress indicators nitric oxide (NO), interleukin-1β (IL-1β) and IL-6 in the treatment of mediastinal tumor in children, so as to explore the clinical application value of this surgery. A retrospective analysis was performed on 82 children with mediastinal tumor undergoing operation in Children's Hospital Affiliated to Zhengzhou University from January 2012 to January 2016. Among them, 48 children undergoing VATS were enrolled as an observation group, and 34 children undergoing conventional thoracotomy were enrolled as a control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the preoperative and postoperative expression levels of NO, IL-1β and IL-6. The intraoperative clinical data, postoperative pain degree and infection rate were observed and recorded in real time, and then compared between the two groups. Before operation (T 0), there were no statistically significant differences between the two groups in serum NO, IL-1β and IL-6 expression levels, which were lower in the observation group than those in the control group at 12 h (T 1) and 24 h (T 2) after operation (P<0.05). The visual analog scale (VAS) score in the observation group was lower than that in the control group at T 1 (P<0.05). Compared with the control group, the largest blade opening, intraoperative blood loss, drainage duration and postoperative pain degree were significantly improved in the observation group. The postoperative infection rate was 4.17% in the observation group, significantly lower than 17.64% in the control group. VATS is effective for postoperative pain stress indicators and infection control in children with mediastinal tumor, which is therefore more suitable for children with the disease and has a higher clinical value.

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Video‐assisted thoracoscopic surgery can help enable the complete resection of a mediastinal tumor caused by immunoglobulin G4‐related disease and avoid the need for postoperative medication: A case report

Cited by 4 publications

References 6 publications

Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with immunoglobulin G4- related disease: a case report

Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with immunoglobulin G4- related disease: a case report

Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with immunoglobulin G4-related disease: a case report

Effect of video‑assisted thoracoscopic surgery on pain stress indicators NO, IL‑1β and IL‑6 in the treatment of mediastinal tumor in children

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