Primary mediastinal choriocarcinoma is a very rare malignant tumor unrelated to pregnancy. Here a case of primary mediastinal choriocarcinoma was reported. The patient was a 13-year-old boy. He presented with shortness of breath, chest pain, fever, irritable cough and weight loss. The imaging examination showed a huge space-occupying lesion at the right edge of mediastinum. The autopsy results showed right lung and mediastinal choriocarcinoma cell carcinoma. After the introduction of the case, this paper reviewed the clinical characteristics, diagnosis and treatment of primary mediastinal choriocarcinoma.
Adolescent ; Choriocarcinoma, Non-gestational ; diagnosis ; pathology ; therapy ; Diagnosis, Differential ; Humans ; Male ; Mediastinal Neoplasms ; diagnosis ; pathology ; therapy

Humans ; Mediastinal Neoplasms/therapy* ; Superior Vena Cava Syndrome/therapy* ; Vena Cava, Superior/surgery*

Consensus ; Humans ; Mediastinal Neoplasms/therapy* ; Superior Vena Cava Syndrome/therapy* ; Vena Cava, Superior

Paragangliomas are unusual neuroendocrine cell tumors arising from paraganglia, of which ACTH-secreting cases in the mediastinum are extremely rare. A 51-year-old woman was admitted for generalized edema and weakness which began 5 months ago. Chest X-ray and CT scan revealed a tumor mass in the anterior mediastinum. The plasma cortisol and ACTH levels were very high. Other sources secreting ACTH, except mediastinal mass, were not found. Surgical excision of mediastinal mass and left supraclavicular lymph node was performed. The postoperative microscopic finding and immunohistochemical staining revealed organoid tumor cell nests (zellballen) and S-100 protein positive sustentacular cells which are characteristics of paraganglioma. This was thus a case of Cushing's syndrome resulting from ectopic ACTH production in anterior mediastinal paraganglioma.
Case Report ; Corticotropin/secretion+ACo- ; Cushing Syndrome/etiology+ACo- ; Female ; Human ; Mediastinal Neoplasms/therapy ; Mediastinal Neoplasms/secretion ; Mediastinal Neoplasms/complications+ACo- ; Middle Age ; Paraganglioma, Extra-Adrenal/therapy ; Paraganglioma, Extra-Adrenal/secretion ; Paraganglioma, Extra-Adrenal/complications+ACo-

We report on nine years experience of surgical treatment of mediastinal tumors in 47 patients. Their ages ranged from 5 to 67 years with an average of 36.4 years and the sex ratio of male and female was 1:1.5. The most frequent symptom was chest pain(27.7%), followed by ptosis(14.9%), general weakness(12.8%) and eight patients(17.0%) were asymptomatic. The most prevalent location of the tumor was anterosuperior mediastinum(63.8%). Pathologically, thymoma(32.9%) was the most common tumor, followed by cyst(21.3%), neurogenic tumor(17.0%), germ cell tumor(12.8%), and mesenchymal tumor(6.4%). Complete removal was achieved in 41 cases of all benign tumors and 3 cases of malignant tumors. All the malignant tumor patients were treated with chemotherapy, radiotherapy or both after surgery. Postoperative complications developed in 4 cases and there was no operative death.
Drug Therapy ; Female ; Germ Cells ; Humans ; Male ; Mediastinal Neoplasms ; Postoperative Complications ; Radiotherapy ; Sex Ratio ; Thorax

This study was aimed to investigate the clinical manifestation, pathological features, treatment and related prognosis factors of primary mediastinal large B cell lymphoma (PMLBCL). The clinical data of 29 PMLBCL patients admitted in Peking University First Hospital were summarized and the related factors were analyzed retrospectively from January 2000 to November 2013. The results showed that 29 patients with the median age 32 were all pathologically diagnosed as PMLBCL. The main clinical features included mediastinal bulk mass (72.4%), superior vena caval syndrome (51.7%), dyspnea (62.1%), serous membrane fluid (48.3%), with 62.1% extranodal invasion and 62.1% extra-thoracic involvement. According to Ann-Arbor stage, 16 patients (55.1%) were classified to stage I/II and 13 patients (44.9%) to stage III/IV, 12 patients (41.4%) had B symptoms. Among the 29 patients, 2 patients failed to be followed and the others were followed for the median time of 29 months, 17 patients achieved CR, 5 patients achieved PR, 1 patient replaced and 4 patients died of disease progression. The 5-year overall survival rate (OS) was 85.2%, in which RCHOEP regimen group patients had OS 94.4% and CHOEP group patients had OS 75%; 8 patients underwent auto-HSCT and 1 patients underwent allo-HSCT who kept in CR state. Univariate analysis by log-rank test showed albumin level and LDH ≥ 2ULN, the initial therapy response and IPI score were prognostic factors , but neither were independent prognostic factors by Cox Regression Model. It is concluded that PMLBCL has distinct clinical features. RCHOEP chemotherapy regimen can achieve satisfactory results, but needs to be explored by further clinical trials.
Follow-Up Studies ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; therapy ; Mediastinal Neoplasms ; diagnosis ; therapy ; Prognosis ; Retrospective Studies ; Survival Rate

Thymic carcinoid tumor is a rare mediastinal tumor, which was firstly described by Rosai and Higa in 1972. A carcinoid tumor of the thymus has recently been regarded as a distinct tumor from thymoma, and is probably Kultschizky cell origin. The pathologic diagnosis of thymic carcinoid is made from findings from light microscopy, immunohistochemical studies and electron microscopy. About 50% of thymic carcinoids were seen with endocrinopathies. Recurrences and extrathoracic metastasis are characteristics of thymic carcinoids. Surgical removal of the intial and tumor recurred are considered to be the most effective treatment today. However, the role of the adjuvant radiotherapy and the chemotherapy is still uncertain. Herein we report a case of thymic carcinoid tumor, which was confirmed by operation and pathologic study.
Carcinoid Tumor* ; Diagnosis ; Drug Therapy ; Mediastinal Neoplasms ; Microscopy ; Microscopy, Electron ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Thymoma ; Thymus Gland ; Thymus Neoplasms

A 15-year-old male was admitted with right-sided chest pain and cough for one month. On chest computed tomographic scan, a 10 x 15 x 16 cm-sized huge mediastinal mass was occupied in the right hemithorax. Radiologically, it seemed that the tumor was severely adhesive on the heart and the superior vena cava. Therefore we decided on chemotherapy and radiotherapy first instead of surgery. The tumor marker was nearly normalized afterwards, but the tumor size was seemed to be bigger on chest tomographic scan. This suggests the growing teratoma syndrome. After the successful resection, he showed symptomatic improvement and is being followed up without any symptoms in an out patient department up to now.
Adhesives ; Adolescent ; Chest Pain ; Cough ; Drug Therapy ; Heart ; Humans ; Male ; Mediastinal Neoplasms ; Radiotherapy ; Teratoma* ; Thorax ; Vena Cava, Superior

A 72-year-old man presented with aggravating dyspnea and swelling of the face due to thymic carcinoma, which was diagnosed based on a transfemoral biopsy specimen. Chest computed tomography and transthoracic echocardiogram showed a mediastinal mass that invaded the superior vena cava and the right atrium. The patient underwent successful chemotherapy with multimodal regimens including cyclophosphamide, vincristine and the dyspnea, facial edema improved. Here, we present a case of spreading thymic carcinoma identified as an intraluminal growth spreading from the mediastinum into the superior vena cava and cardiac cavity.
Aged ; Biopsy ; Cyclophosphamide ; Drug Therapy ; Dyspnea* ; Edema ; Heart Atria ; Heart Neoplasms ; Humans ; Mediastinal Neoplasms ; Mediastinum ; Thorax ; Thymoma ; Thymus Gland* ; Thymus Neoplasms* ; Vena Cava, Superior ; Vincristine

A 72-year-old man presented with aggravating dyspnea and swelling of the face due to thymic carcinoma, which was diagnosed based on a transfemoral biopsy specimen. Chest computed tomography and transthoracic echocardiogram showed a mediastinal mass that invaded the superior vena cava and the right atrium. The patient underwent successful chemotherapy with multimodal regimens including cyclophosphamide, vincristine and the dyspnea, facial edema improved. Here, we present a case of spreading thymic carcinoma identified as an intraluminal growth spreading from the mediastinum into the superior vena cava and cardiac cavity.
Aged ; Biopsy ; Cyclophosphamide ; Drug Therapy ; Dyspnea* ; Edema ; Heart Atria ; Heart Neoplasms ; Humans ; Mediastinal Neoplasms ; Mediastinum ; Thorax ; Thymoma ; Thymus Gland* ; Thymus Neoplasms* ; Vena Cava, Superior ; Vincristine