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E.H. Yardimci
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 2
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-039 - Solitary Fibrous Tumor of the Pleura Associated with Gynecomastia: A Case Report (ID 5771)
14:30 - 14:30 | Author(s): E.H. Yardimci
- Abstract
Background:
Fibrous tumor originated from pleura is a rarely seen lung tumor. It can be malignant or benign, and may cause paraneoplastic syndromes.
Methods:
In this study, we retrospectively evaluated a case in which a lung mass was detected during examination of the gynecomastia and operated in our hospital with the diagnosis of solitary fibrous tumor of the pleura.
Results:
53-year-old male patient was admitted to our clinic with the complaint of bilateral painful breast enlargement. Symmetrical gynecomastia with benign findings was detected in Category 2 level according to Breast Imaging-Reporting and Data System (BI-RADS) classification in the bilateral breast ultrasonography investigations. Thorax computed tomography imagination showed extrapleurally located mass lesion with solid character and 75x25mm in size. Mesothelial cells were observed in the material received by the computed tomography-guided needle biopsy. Thereupon, a decision was made to take the patient to the operation. Frozen section procedure was performed on the specimen received by video-assisted thoracic surgery (VATS) biopsy. Diagnosis could not be achieved therefore it was decided to perform resection by mini-thoracotomy due to the size and rigid structure of the mass. During the process, it was observed that fibrous mass was holding on to the right middle lobe with a pedicle and it was found to be free in the other regions. The entire mass was removed with the resection including the surrounding healthy parenchymal tissue and the operation was terminated. The patient was discharged on the postoperative day 3. In the pathological examination, a solitary fibrous tumor associated with visceral pleura in the dimensions of 85x55x27 mm was reported with the features of low mitotic activity, and focal hypercellularity, and showing strong positive staining for CD34, CD99 and Bcl-2. In the additional investigations in gynecomastia clinics, it was observed that tumor cells were stained at 67-70% with progesterone and 35-40% with estrogen. Staining with β-Hcg was not observed.
Conclusion:
Solitary fibrous tumors of pleura is rare. These tumors originate from mesenchymal cells, not from mesothelial cells. These solitary fibrous tumors may be malignant or benign. These tumors may be asymptomatic, may cause symptoms of pressure or may lead to paraneoplastic syndromes. Recurrence can happen. Appropriate surgical intervention should be selected.
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P3.04-040 - A Rare Case of Intrathoracic Mass: Intrathoracic Desmoid Tumor (ID 5762)
14:30 - 14:30 | Author(s): E.H. Yardimci
- Abstract
Background:
Desmoid tumor is a rare type of tumor which originates from abdominal fascial and musculo-aponeurotic structure. It generally occurs in the abdomen, but rarely may be derived from the chest wall. Pain is the main complaint of the patients admitted to hospital.
Methods:
In this study, we retrospectively evaluated the pre-surgical diagnostic methods, surgical intervention and post-operative follow-up processes and outcomes of a patient who admitted to hospital with a complaint of back pain and were operated in our hospital with the diagnosis of desmoid tumor.
Results:
57-year-old male patient was admitted to our clinic with tha complaints of left arm and back pain suffered approximately more than 1 year. Due to the increasing pain and ptosis in the left eye, imaging studies were performed and a mass was detected in the left hemithorax. Needle biopsy was applied to the patient two times but no results were obtained. Whereupon, the patient was referred to our clinic. During the physical examination of the patient in our clinic, a mild ptosis in his left eye, palpable and hard fixed mass in the left supraclavicular fossa and loss of breath sounds in the upper left side of the hemithorax were detected. Thorax computed tomography imagination showed an extrapleural mass, 17x13x12 cm in size, which fills the superior and posterior mediastinum with the plexus. Additionally, a mass, 154x114x114 mm in size was reported with SUV upper value of 4.85, consisting with malignancy in the PET-computed tomography. Upon this, posterolateral thoracotomy surgery was applied to the patient and the mass was removed en bloc. The mass was reported as a desmoid tumor based on the pathological findings and the patient was discharged on the postoperative day 6. In the 3rd month of follow-up process, 54 Gy / 30 fr radiotherapy was applied to the left hemitorax apical tumor location. In the control imaging studies following 3., 8., 24. and 30. months of the surgery, no lesion compatible with the recurrence was detected.
Conclusion:
Desmoid tumor is a rare type of tumor originating from abdominal fascial and musculo-aponeurotic structure. Surgical resection is needed. Because of the possibility of recurrence, surgical intervention should be modified in a way to remain the quality of patient's life.
