Medicina, Vol. 55 No. 1, 2019.
Ostalo
https://doi.org/10.21860/medflum2019_216315
Mediastinal smooth muscle tumor of uncertain malignant potential: case report and literature review
Veljko Flego
orcid.org/0000-0002-6333-9883
; Specijalna bolnica za medicinsku rehabilitaciju Thalassotherapia Crikvenica, Crikvenica, Hrvatska
Darian Volarić
orcid.org/0000-0001-5702-4749
; Katedra za internu medicinu, Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska
Koviljka Matušan Ilijaš
; Zavod za patologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Ljiljana Bulat-Kardum
; Zavod za pulmologiju, Klinika za internu medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Sažetak
Aim: Smooth muscle tumors are divided into leiomyomas and leiomyosarcomas. The aim is to present a patient with a rare tumor called smooth muscle tumor of uncertain malignant potential. Case report: The reported patient was a 48-year-old male, subfebrile, with chest pain. Chest computed tomography showed a sharply limited cystic formation of the posterior mediastinum. Esophagogastroduodenoscopy revealed outside compression in the middle third of the esophagus, and X-ray of the esophageal passage showed that the esophagus was pressed from the outside to the right and ventral. Bronchoscopy determined that the membranous part of the left main bronchus was slightly extramurally compressed. A left thoracotomy and an extirpation of the mediastinal tumor were performed. In pathohistology area of necrosis and tumor tissue composed of spindle cells were identified, which showed mild polymorphia. Immunohistochemical findings included positive smooth muscle actin (SMA) and desmin markers, negative S100 and CD34 markers, Ki-67 was 5.9%, and p16 was positive in more than 50% of tumor cells. The patient was followed up for 48 months, with no signs of tumor recurrence. Conclusion: Pathohistological diagnosis can be difficult, particularly in cases of rare neoplasms. The reported case shows that sometimes it is not possible to determine if smooth muscle tumor is benign or malignant. Therefore, the diagnosis of smooth muscle tumor of uncertain malignant potential is established, in our case the tumor was located in the mediastinum. After surgical removal of the neoplasm, the patient should be followed up regularly in order to detect disease recurrence and to give additional treatment.
Ključne riječi
immunohistochemistry; malignancy; mediastinal neoplasms; smooth muscle tumor
Hrčak ID:
216315
URI
Datum izdavanja:
1.3.2019.
Posjeta: 1.857 *