A 44-year-old man was transferred to our department for mediastinal mass. He had suffered from only an easily fatiguable condition for 1 month. A physical examination and laboratory finding of the patient disclosed no abnormality. A chest radiograph showed a soft tissue tumor in the posterior mediastinum. It was well circumscribed and ovoid. Invasions to adjacent organs were not seen. Therefore it was though the 5th intercostal space. The tumor mass was attached to the visceral pleura of the right upper lobe by a pedicle and this pedunculated tumor laid entirely within the pleural cavity. Excision of the tumor which measured 7x7x3cm was done easily. Pathologic studies confirmed the diagnosis of localized fibrous tumor of the pleura. Localized fibrous tumor of the pleura is rare, This tumor along ith the evidence from ultrastructural and immunohistochemical studies has led most researchers to conclude that localized fibrous tumor is not of the mesothelial origin but arises in the submesothelial connective tissue.
Adult ; Connective Tissue ; Diagnosis ; Humans ; Mediastinum ; Mesothelioma ; Physical Examination ; Pleura* ; Pleural Cavity ; Pleural Neoplasms ; Radiography, Thoracic

Synovial sarcoma is a rare malignancy in the thoracic cavity, especially in the mediastinum. In this paper, a case of primary mediastinal synovial sarcoma is reported. A 34-year-old woman was hospitalized with dyspnea. Her chest X-ray and computed tomography (CT) showed a 16x13x11 cm mass in her anterior mediastinal space. Surgical resection was performed but was incomplete. The pathological and immunohistochemical analysis confirmed the diagnosis of monophasic spindle cell synovial sarcoma. The patient underwent adjuvant radiotherapy for two months, but local recurrence and metastasis occurred in her pleural cavity. She eventually underwent chemotherapy for one year and died 18 months after her operation.
Dyspnea ; Female ; Humans ; Mediastinum ; Neoplasm Metastasis ; Pleural Cavity ; Radiotherapy, Adjuvant ; Recurrence ; Sarcoma ; Sarcoma, Synovial ; Thoracic Cavity ; Thorax

In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity. We report a case of a 63-year-old male with a large invasive thymic carcinoma in the anterior mediastinum. The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles. The patient underwent subtotal sternectomy, radical thymectomy, and reconstruction with biological mesh (Permacol). Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.
Collagen ; Humans ; Intercostal Muscles ; Male ; Mediastinum ; Pleural Cavity ; Ribs ; Sternum ; Thoracic Wall ; Thymectomy ; Thymoma

PURPOSE: The purpose of this report is to evaluate the characteristic findings of tuberculosis of the breast on mammogram, sonogram, and CT and to compare the results with the imaging features of non-tuberculous mastitis. MATERIALS AND METHODS: Using mammograms and sonograms, nine cases of tuberculosis of the breast were evaluated, and for four cases, CT was used. Aspects evaluated were contour, shape and size of the lesion, homogeneity ofinternal content, and extension of the lesion from/to the adjacent organs. Diagnosis was based on aspiration,surgery, and pathologic findings including acid-fast bacillus (AFB) staining. Mammograms and sonograms of 19 patients with non-tuberculous mastitis of the breast were reviewed. RESULTS: No cases of tuberculous mastitis presented clinical evidence of acute inflammation such as fever, swelling or skin redness. Nine cases of tuberculous mastitis were seen as a distinct mass on mammogram and sonogram. Four of nine cases (44.4%) showed arelatively smooth peripheral margin on mammogram and a cold abscess form on sonogram and CT. There were other fociof tuberculosis in the chest wall, anterior mediastinum, pleural cavity or lung. Five cases demonstrated as a nodular type on US. In the non-tuberculous mastitis group, an abscess with distinct margin or direct contiguity between a breast lesion and the adjacent organ was observed neither on mammogram nor on sonogram. CONCLUSION: Inan afebrile patient, relative homogeneous density with distinct margin in the breast on mammogram and a fistulous connection or direct continuity between breast abscess form with the adjacent organ on sonogram or CT is acharacteristic feature of the tuberculous mastitis. The cold abscess type is a frequent subtypes of this entity, and must also be included.
Abscess ; Bacillus ; Breast ; Diagnosis ; Female ; Fever ; Humans ; Inflammation ; Lung ; Mastitis* ; Mediastinum ; Pleural Cavity ; Skin ; Thoracic Wall ; Tuberculosis

Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it's locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 cm at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.
Accidents, Traffic ; Adult ; Female ; Follow-Up Studies ; Humans ; Mediastinal Neoplasms ; Mediastinum* ; Pericardium ; Pleural Cavity ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thoracoscopy

Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it's locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 cm at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.
Accidents, Traffic ; Adult ; Female ; Follow-Up Studies ; Humans ; Mediastinal Neoplasms ; Mediastinum* ; Pericardium ; Pleural Cavity ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thoracoscopy

A 55-year-old female presented to Pusan National University Yangsan Hospital with left neck and shoulder pain. An anterior mediastinal mass was detected on chest CT and there were no other specific lesions in the lung or pleural cavity. An infected pericardial cysts was suspected and excision was performed through a left-sided VATS approach. The patient was discharged on the second post-operative day with left diaphragm palsy and praziquantel was prescribed after paragonimaisis was confirmed on pathology. The patient has not shown any particular problems at my outpatient clinic.
Ambulatory Care Facilities ; Diaphragm ; Female ; Humans ; Lung ; Mediastinal Cyst ; Mediastinum ; Middle Aged ; Neck ; Paragonimiasis ; Paralysis ; Pleural Cavity ; Praziquantel ; Shoulder Pain ; Thoracic Surgery, Video-Assisted ; Thorax

Desmoid tumors are rare soft tissue tumors arising from the fascia or from musculoaponeurotic structures. They are commonly seen in the extremities, but are rarely found in the thorax. Thoracic desmoid tumors commonly arise from the chest wall and rarely in the thoracic cavity. Imaging diagnosis of an intrathoracic desmoid tumor is difficult because there are no specific imaging findings for a desmoid tumor that can be differentiated from the various tumors of the chest wall, including a solitary fibrous tumor of the pleura. All desmoid tumor cells show negative immunohistochemical staining for CD34 in pathological specimen, a feature that makes it possible to differentiate a desmoid tumor from a solitary fibrous tumor of the pleura. Desmoid tumors are locally aggressive and the rate of local recurrence is very high. Consequently, wide radical resection is required and a preoperative accurate diagnosis of desmoid tumors is warranted. We describe the radiological findings of various imaging studies for an intrathoracic desmoid tumor. Our findings should facilitate a proper diagnosis of desmoid tumors.
Diagnosis ; Extremities ; Fascia ; Fibromatosis, Aggressive* ; Recurrence ; Solitary Fibrous Tumor, Pleural ; Thoracic Cavity ; Thoracic Wall ; Thorax

Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.
Fascia ; Hematoma ; Hemothorax ; Pleura ; Pleural Cavity ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Thoracoscopy ; United Nations

We report here on a case of double bypass of the esophagus and descending thoracic aorta for the treatment of esophagopleural fistula and aortopleural fistula due to an infected aortic aneurysm after esophageal rupture. A 48 year old man was diagnosed as having esophageal rupture after an accidental explosion. Although he had been treated by esophageal repair and drainage at another hospital, the esophageal leakage could not be controlled and subsequent empyema developed in the left pleura. Further, bleeding from the descending thoracic aorta had developed and he was managed with endovascular stent insertion to the descending thoracic aorta. He was transferred to our hospital for corrective surgery. We performed esophago - gastrostomy via the substernal route, without exploring posterior mediastinum and we let the empyema resolve spontaneously. While he was being managed postoperatively without any signs and symptoms of infection, sudden bleeding developed from the left pleural cavity. After evaluation for the bleeding focus, we discovered an infected aortic aneurysm and an aortopleural fistula at the stent insertion site. We performed a second bypass procedure for the infected descending thoracic aorta from the ascending aorta to the descending abdominal aorta via the right pleural cavity. We found leakage at the distal ligation site during the immediate postoperative period, and we occluded the leakage using a vascular plug. He discharged without complications and he is currently doing well without any more bleeding or other complications.
Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm ; Drainage ; Empyema ; Empyema, Pleural ; Esophageal Perforation ; Esophagus ; Explosions ; Fistula ; Gastrostomy ; Hemorrhage ; Ligation ; Linear Energy Transfer ; Mediastinum ; Pleura ; Pleural Cavity ; Postoperative Period ; Rupture ; Stents