Thoracoscopic resection of a solitary pulmonary lymphangioma: Report of a case

We present herein the rare case of a young man who was found to have a solitary tumor in the right upper lobe of his lung by a routine chest X-ray. The tumor was removed by thoracoscopic surgery, and pathological examinations confirmed the diagnosis of a primary lymphangioma of the lung. A brief review of the available literature on this extremely rare type of benign tumor follows the case report.     

Primary Osteosarcoma of the Lung: Report of a Case

Osteosarcoma of the lung without an extrathoracic primary tumor is extremely rare, with only eight cases documented in the literature, to the best of our knowledge. We report a case of primary osteosarcoma of the lung found in an asymptomatic 74-year-old woman. Computed tomography showed a heterogeneous mass beside the aortic arch, and the patient underwent a left upper lobectomy. The pathology results confirmed a diagnosis of primary osteosarcoma.     

Recurrent arterial embolization from a metastatic germ cell tumor invading the left atrium

Arterial embolization of a malignant tumor is extremely rare. We report an unusual case of a young adult man who presented with acute lower limb ischemia and a mass in the right lung and left atrium. These clinical manifestations were the result of metastases and embolization from a germ cell tumor and were the first indication of malignancy in this patient. The importance of appropriate investigations in the subsequent treatment is stressed.     

Intrarenal neuroblastoma with pulmonary metastases mimicking a Wilms tumor

Primary intrarenal neuroblastoma is extremely rare and is a mimic of Wilms tumor. We present a case of a renal mass in a 14 month old male with lung metastases at the initial presentation. This was thought to represent a Wilms tumor. Histology of a biopsied lung nodule revealed neuroblastoma.     

Pulmonary sclerosing hemangioma with pleural dissemination: Report of a case

Pulmonary sclerosing hemangioma is relatively rare and is usually considered a benign tumor. There have been no reports of pulmonary sclerosing hemangioma with pleural dissemination. This report presents an extremely rare case of pulmonary sclerosing hemangioma with pulmonary dissemination. A 57-year-old woman was found to have an abnormal shadow in the right lower lung field on chest X-ray. Chest computed tomography (CT) indicated a 2.5-cm mass in the right lower lobe. A bronchoscopic biopsy failed to identify malignant cells, which led to the patient undergoing an excisional lung biopsy. Intraoperative findings showed a tumor in the right lower lobe with multiple small nodules in the pleura. The pathological findings revealed that the tumor was sclerosing hemangioma with pleural dissemination. Annual follow-up CT showed irregular pleural thickness, which suggested progressive dissemination 3 years after the operation. Although pulmonary sclerosing hemangioma is regarded as a benign tumor, the potential for malignancy may be a consideration in this setting.     

Arteriovenous hemangioma in the middle mediastinum: Report of a case

Hemangiomas in the mediastinum are uncommon, and the majority of these tumors are located in the anterior mediastinum. The present report describes an extremely rare case of a hemangioma in the middle mediastinum. A 40-year-old male patient presented with a mass in the left lower lung field on radiographic screening. Chest computed tomography and magnetic resonance imaging revealed a mass measuring 2.5 cm in diameter, which was close to the descending aorta in the left middle mediastinum. The tumor resection was performed by video-assisted thoracic surgery. The thoracoscopic findings revealed a blackish brown mass with a capsule, which had not invaded the descending aorta or cardiac sac. Histologically, the tumor was composed of typical thick-walled vessels and was therefore classified as an arteriovenous hemangioma.     

Pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma

INTRODUCTIONPrimary Pulmonary Mucinous Cystadenocarcinoma PPMC is an extremely rare subtype of pulmonary adenocarcinoma, with only a few dozen cases reported in the literature to date.PRESENTATION OF CASEWe report a extremely rare case of pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma. 53-year-old man exposed to asbestos, he is admitted in hospital with a 5 cm mass in right pleura. He was treated by wedge resection. Sparse groups of malignant cells were microscopically observed in pools of mucin. The postoperative histopathological findings were in accordance with the diagnosis of pulmonary mucinous cystadenocarcinoma on cystic adenoid malformation of lung. 5 years later, the patient has no recurrence.DISCUSSIONPPMC is usually asymptomatic; hemoptysis is seen occasionally. Preoperative diagnosis is very difficult to establish. Both FNA cytology and transbronchial lung biopsy seem inadequate. Our patient went on to undergo open lung biopsy and histopathological testing that confirmed the diagnosis of PMC.CONCLUSIONIt is important to differentiate this rare pathological feature of the lung from other lung tumors as the treatment is surgical rather than medical. Thoracic surgeons should bear in mind this rare tumor for the differential diagnosis of a pleural mesothelioma because this tumor has a favorable prognosis.     

Successfully treated lingual tonsillar metastasis from bronchial adenocarcinoma

Tonsillar metastasis from neoplasms, including lung cancer, are extremely rare, and the prognosis for patients with tonsillar metastases is rather poor. We herein describe a case of long-term survival follow-ing radiation for lingual tonsillar metastasis from a bronchial adenocarcinoma. A 39-year-old male was diagnosed with adenocarcinoma of the right lung and was surgically treated. Four months after surgery, a mass arising from the lingual tonsil was noted at the root of the tongue and was pathologically diagnosed as metastasis from lung cancer. In addition, a computed tomography scan revealed a jugular lymphadenopathy, which was considered to be a metastasis from the tonsillar tumor. The tonsillar mass and jugular lymphadenopathy disappeared after external radiotherapy (50 Gy). The patient is alive without recurrence more than 8 years after treatment for tonsillar metastasis. This is the first report of successfully treated tonsillar metastasis from a malignant tumor.     

Focal thymic hyperplasia in an adult: Report of a case

We report herein an unusual case of a 35-year-old Japanese man who underwent thoracotomy for a mass in the mediastinum which was found to be a well circumscribed localized tumor within the thymus. Focal thymic hyperplasia in adults is extremely rare and the clinicopathological features of this case were particularly interesting and posed great difficulty in establishing a diagnosis.     

Angiolymphoid hyperplasia with eosinophilia on penile skin in a 7-year-old child

We report a case of a 7-year-old child who presented with a painless mass on his penis. He underwent removal of the mass, which was found to be an angiolymphoid hyperplasia with eosinophilia. Angiolymphoid hyperplasia with eosinophilia is an extremely rare tumor, especially in children's penis. In this situation, treatment of this tumor should be considered carefully, and there is a chance of spontaneous regression after volume reduction surgery.     

Multiple primary pulmonary meningiomas: 20-year follow-up findings for a first reported case confirming a benign biological nature

IntroductionPrimary pulmonary meningiomas (PPMs) are very rare neoplasms, and we reported the first multiple case of PPMs in 1998. Usually, PPMs are slow-growing tumors with a good prognosis. Herein, we reported a rare multiple case of PPMs with an extremely long clinical course.Presentation of the caseAn 84-year-old Japanese woman with a history of multiple PPMs histologically confirmed as having a right-sided slowly growing lung nodule for 20 years. In 2010, we also reported the additional clinical course in the initial case 10 years after surgery implying a benign biological nature. Subsequent to that report, new lesions appeared in the bilateral lung fields with quite a slow growth rate. She was asymptomatic, and no tumor was observed in the cranial cavity during the course of her disease.Discussion and conclusionThis case illustrates rare multiple PPMs and highlights their biological behavior with very slow progression from a most likely benign tumor over a 20-year period.     

Carcinosarcoma of the lung mis-diagnosed preoperatively as a mediastinal tumor

Carcinosarcoma of the lung is an uncommon tumor and is rarely preoperatively correctly diagnosed. The prognosis of patients with carcinosarcoma is extremely poor, despite treatment. A 79-year-old man was mis-diagnosed preoperatively as having a malignant mediastinal tumor. Excision of the tumor with segmentectomy of the lung revealed it was composed of a variety of carcinomatous and sarcomatous elements, which is a clear manifestation of the histogenetic totipotentiality of carcinosarcoma. He was subsequently treated with adjuvant chemotherapy and irradiation. He remains well at sixteen months after the operation, to date. Here we report this rare true case of a carcinosarcoma, focusing on the difficulty of a correct preoperative diagnosis.     

Carcinosarcoma of the lung mis-diagnosed preoperatively as a mediastinal tumor.

Carcinosarcoma of the lung is an uncommon tumor and is rarely preoperatively correctly diagnosed. The prognosis of patients with carcinosarcoma is extremely poor, despite treatment. A 79-year-old man was mis-diagnosed preoperatively as having a malignant mediastinal tumor. Excision of the tumor with segmentectomy of the lung revealed it was composed of a variety of carcinomatous and sarcomatous elements, which is a clear manifestation of the histogenetic totipotentiality of carcinosarcoma. He was subsequently treated with adjuvant chemotherapy and irradiation. He remains well at sixteen months after the operation, to date. Here we report this rare true case of a carcinosarcoma, focusing on the difficulty of a correct preoperative diagnosis.     

Adult Cecoanal Intussusception Caused by Cecum Cancer: Report of a Case

We report a case of cecoanal intussusception caused by cecum cancer in a 29-year-old woman. The patient presented to our hospital with a mass protruding from the anus. We manually pushed the mass back into the rectum and performed a gastrograffin enema, which showed a cup-shaped filling defect in the rectum. The defect was moved back to oral side with the pressure of the enema, revealing a tumor originating in the cecum. Colonoscopy showed a protrusion, 5 × 3 cm in size, in the cecum. Laparotomy confirmed that the tumor originated at the bottom of the appendix in the cecum. We performed partial resection of the cecum containing the tumor and appendix. The pathological finding was submucosal adenocarcinoma in adenoma. Cecoanal intussusception is extremely rare and, to our knowledge, this adult case represents the first report documented in the world scientific literature.     

Periodic appearance and disappearance of a chest wall (serratus anterior development) cavernous hemangioma that was finally resected in a child

Primary chest wall tumors occur infrequently; in particular, cavernous hemangioma of the chest wall is an extremely rare disease. We report a case of child with cavernous hemangioma of the chest wall, which was successfully resected. Obvious enlargement of the tumor and the appearance of pain were observed during a 2-year follow-up. In the present case, transcutaneous ultrasonography showed the appearance and disappearance of the mass. This was considered to be caused by the transfer of contents between the shallow and deep parts of the tumor. This may have resulted from serratus anterior muscle movement between the two-layered tumor. Transcutaneous ultrasonography, as well as magnetic resonance imaging, was therefore extremely effective for preoperative diagnosis. Transcutaneous ultrasonography is easily performed, even in children, such as in the present case. Because of its simplicity and usefulness, transcutaneous ultrasonography may be considered as the first-line imaging modality for diagnosis.     

Intercostal arteriovenous hemangioma.

We report a case of a 46-year-old man who presented with a chest wall tumor in the right hemithorax. He underwent thoracotomy to remove the mass, which was found to be an arteriovenous hemangioma arising from the intercostal muscle. Arteriovenous hemangioma is a rare tumor and chest wall is an extremely rare site for this tumor. This tumor should be considered in the differential diagnosis of the chest wall tumors. Complete surgical excision offers the best treatment.     

Large, benign osteoblastoma of the temporal bone--case report

Benign osteoblastoma is a rare tumor of bone, usually confined to the long bones and vertebrae. Its occurrence in the calvaria is extremely rare. The authors report a case of a temporoparietal lesion in a 29-year-old male. Computed tomography revealed a low-density mass, which was irregularly enhanced by contrast medium. Magnetic resonance imaging demonstrated a mass of low intensity on T1- and high intensity on T2-weighted images. Angiography confirmed the presence of a large epidural mass in the left temporal region. The tumor was excised and the pathological diagnosis was benign osteoblastoma.     

Infantile myofibromatosis with a solitary lesion in the skull--case report.

The term "infantile myofibromatosis" was coined in 1981 to describe a rare type of soft-tissue tumor in infants. Solitary lesions are usual, but extremely rare in the skull. An infantile case involving a lesion in the left parietal bone is described. The patient was a 6-month-old girl admitted with a mass measuring 2 x 2 cm in the left parietal region. Skull x-rays showed an osteolytic lesion with a sclerotic margin in the parietal bone. Computed tomographic (CT) scans revealed a low-density mass with homogeneous enhancement. The tumor adhered to the dura and had destroyed the left parietal bone. Histological examination disclosed spindle-shaped cells arranged in short bundles and abundant vasculature. Phosphotungstic acid hematoxylin staining revealed longitudinal fibrils resembling myofibroblasts. This is the first report in which CT findings are described in a case of infantile myofibromatosis with a solitary lesion occurring in the skull.     

Intercostal lung hernia in a 7-year-old boy

The authors report a case of a lateral chest wall lung hernia, which was presumably congenital. Lung herniations are extremely rare, and congenital herniation of the lung through an apparently intact thoracic cage has not yet been reported. The hernia was repaired by the interposition of a polypropylene mesh. The literature of this rare condition is briefly reviewed.     

Pulmonary pleomorphic liposarcoma

Pulmonary liposarcoma is extremely rare with 6 cases previously reported in the English literature. The following is a report of a 36-year-old man with pulmonary liposarcoma. The patient had chest pain and a mass shadow in the right lower lung field was revealed on a chest X-ray film. A computed tomography and magnetic resonance imaging showed a heterogeneous tumor, compressing the right lower lobe of the lung. Because of the fatty tissue component in the tumor on the chest computed tomography, and the appearance as an extrapulmonary mass, preoperative diagnosis was posterior mediastinal liposarcoma. But thoracotomy revealed that the tumor originated from the lung. Right lower lobectomy and lymph node dissection was carried out with no additional therapy. The pathological diagnosis was pleomorphic liposarcoma originated from the lung. Two months after the operation, the patient died of respiratory failure due to local recurrence.