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Asakawa A, Ishibashi H, Kobayashi M, Shirai T, Okubo K. A rare case of thymoma with entire-tumor calcification. J Surg Case Rep 2021; 2021:rjaa545. [PMID: 33884161 PMCID: PMC8046014 DOI: 10.1093/jscr/rjaa545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/18/2021] [Indexed: 12/04/2022] Open
Abstract
A 49-year-old woman presented with cough, and chest X-rays showed an abnormal shadow. Chest computed tomography showed an anterior mediastinal 40-mm mass with massive calcification. The patient underwent mediastinal tumor excision performed using video-assisted thoracoscopic surgery. Pathological findings revealed the tumor to be a type B3 thymoma, with massive calcification occupying almost all of the thymoma. Due to high risk of recurrence, we performed completion thymectomy. Pathological findings revealed no remaining thymoma tissue in the residual thymus. Mediastinal tumor with entire calcification could be a candidate for surgical excision.
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Affiliation(s)
- Ayaka Asakawa
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hironori Ishibashi
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masashi Kobayashi
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshizumi Shirai
- Department of Cardio-Thoracic Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Michaux D, Berzenji L, Keulen L, Rodrigus I. Thymoma mimicking an aortic aneurysm: always expect the unexpected. BMJ Case Rep 2019; 12:12/7/e230073. [PMID: 31320375 DOI: 10.1136/bcr-2019-230073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Thymic epithelial tumours (TETs) are rare lesions that represent less than 1% of all malignancies in adults. Presentation occurs in three ways: asymptomatic, with local thoracic symptoms or with paraneoplastic symptoms. Heterotopic ossifications are rare histological features in neoplasms and non-neoplastic lesions. Here, we present a 49-year-old male patient with a thymoma type B2 mimicking an aortic aneurysm. Alongside the thymoma, a cholesterol granuloma with unusual ossification features was found as well. This clinical presentation and pathological diagnosis are unusual findings.
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Affiliation(s)
- Dario Michaux
- Thoracic and Vascular Surgery, University Hospital Antwerp, Edegem, Antwerpen, Belgium
| | - Lawek Berzenji
- Thoracic and Vascular Surgery, University Hospital Antwerp, Edegem, Antwerpen, Belgium
| | - Lotte Keulen
- Pathology, University Hospital Antwerp, Edegem, Antwerpen, Belgium
| | - Inez Rodrigus
- Cardiac Surgery, University Hospital Antwerp, Edegem, Antwerpen, Belgium
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Jung JJ, Kim SH, Kang DH, Kim KN, Moon SH, Yang JH, Byun JH, Kim JW, Jeon KN, Bae K, Kim HC, Kim JY, Park HO, Choi JY. Invasive thymoma with multiple ring calcifications and osseous metaplasia: A case report. Thorac Cancer 2018; 9:1509-1512. [PMID: 30168289 PMCID: PMC6209803 DOI: 10.1111/1759-7714.12841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 11/26/2022] Open
Abstract
An 8.0 × 7.0 × 3.0 cm calcified anterior mediastinal mass was found in a 57-year-old man during a regular health checkup. The tumor had invaded the pericardium and phrenic nerve. The Masaoka-Koga classification was stage III. Multiple ring calcifications were present in the gross feature, and osseous metaplasia was observed in the histologic examination. World Health Organization histologic classification of the tumor was type B2. The patient is currently undergoing chemotherapy and radiation therapy to prevent tumor recurrence. To our knowledge, this is the first case of multiple ring calcifications and osseous metaplasia in invasive thymoma.
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Affiliation(s)
- Jae Jun Jung
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Sung Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Dong Hoon Kang
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Ki Nyun Kim
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Seong Ho Moon
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jun Ho Yang
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Joung Hun Byun
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jong Woo Kim
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Kyung Nyeo Jeon
- Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea
| | - Kyungsoo Bae
- Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea
| | - Ho Cheol Kim
- Division of Pulmonology and Allergy, Department of Internal Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Ju Young Kim
- Division of Pulmonology and Allergy, Department of Internal Medicine, College of Medicine and Institute of Health Sciences, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Hyun Oh Park
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Jinju, South Korea
| | - Jun Young Choi
- Department of Thoracic and Cardiovascular Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea.,Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Jinju, South Korea
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5
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Farmakis SG, Herman TE, Siegel MJ. Thymoma with osseous metaplasia in an adolescent. Pediatr Radiol 2014; 44:888-92. [PMID: 24442387 DOI: 10.1007/s00247-013-2865-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/11/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022]
Abstract
A 13-year-old girl was incidentally found to have a partially calcified anterior mediastinal mass during the work-up for a left humeral lesion. The resected specimen demonstrated a lymphocyte predominant World Health Organization type B1 thymoma with nodules of metaplastic bone consistent with osseous metaplasia. In addition, she had multiple osteochondromas, a periosteal chondroma of the humerus, a metaplastic osseous pseudotumor of the thigh, and other benign-appearing sclerotic foci, all manifestations of what is likely an autosomal dominant disorder.
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Affiliation(s)
- Shannon G Farmakis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Blvd., St. Louis, MO, 63110, USA,
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Liu K, Tripp S, Layfield LJ. Heterotopic ossification: Review of histologic findings and tissue distribution in a 10-year experience. Pathol Res Pract 2007; 203:633-40. [PMID: 17728073 DOI: 10.1016/j.prp.2007.05.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 02/09/2007] [Accepted: 05/24/2007] [Indexed: 10/22/2022]
Abstract
Heterotopic ossification (HO) within tissues involved by a pathologic process is a well-recognized phenomenon. It is most frequently observed in atherosclerotic plaques, in soft tissue around joints, and in the central nervous system. Less frequently, carcinomas and some benign neoplasms will undergo heterotopic ossification. We performed a retrospective review of our experience with HO over a 10-year period to determine the frequency and tissue site distribution of heterotopic ossification. A computerized review of surgical pathology records of approximately 126,000 reports revealed 85 cases in which heterotopic ossification, ectopic bone or metaplastic bone was specifically mentioned in the surgical pathology diagnosis. Twenty-two cases were neoplasms of non-osseous tissues, and 63 cases were non-neoplastic lesions. Immunohistochemical staining for bone morphogenic proteins (BMP) 1, 4, and 6 was performed. Fourteen cases showed staining for BMP-1, 22 cases showed staining for BMP-4, and five cases showed weak staining for BMP-6. HO is a relatively infrequent finding and is more commonly seen in degenerative and reparative conditions than in neoplasms.
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Affiliation(s)
- Katharine Liu
- Department of Pathology, University Hospital, Augusta, GA, USA
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