Long-term survival after removal of a malignant peripheral nerve sheath tumor originating in the anterior mediastinum.
Malignant peripheral nerve sheath tumors (MPNSTs; malignant schwannomas) rarely occur in the anterior mediastinum, and their prognosis is poor. A 75-year-old man was referred to our hospital for examination of an anterior mediastinal tumor. A computed tomography-guided percutaneous needle biopsy revealed only fibrosis. The tumor was completely excised via a median sternotomy with partial resection of the pericardium and right upper lobe of the lung. Thereafter, the tumor was diagnosed as a storiform-pleomorphic type of malignant fibrous histiocytoma. At 1 year after the surgery, a distant metastasis was found in the interlobular space between the right middle and lower lobes. The tumor was completely excised via a right posterolateral thoracotomy. Reexamination of the primary and secondary tumors revealed an MPNST. No recurrence was found up to 5 years after the second surgery without adjuvant chemotherapy or radiation therapy. However, he died from multiple lung metastases after 6 years.
Shimoyama
Takehiko
T
Division of Chest Surgery, Cancer Center of Niigata Hospital, Niigata, Japan. shimoyama.tsrg@yokohama.jrc.or.jp
Yoshiya
Katsuo
K
Yamato
Yasushi
Y
Koike
Teruaki
T
Honma
Keiichi
K
D000368:Aged; D001707:Biopsy, Needle; D017809:Fatal Outcome; D051677:Histiocytoma, Malignant Fibrous / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000601:surgery*; D018317:Nerve Sheath Neoplasms / Q000556:secondary / Q000601:surgery*; D010492:Pericardiectomy; D011013:Pneumonectomy; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome