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Collins K, Ulbright TM, Davis JL. Anterior mediastinal neuroblastoma in an adult: an additional case of a rare tumor in an unusual location with review of the literature. Diagn Pathol 2023; 18:127. [PMID: 38031161 PMCID: PMC10685643 DOI: 10.1186/s13000-023-01417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
Neuroblastoma is rare in the adult population, especially in thoracic or mediastinal locations, with only 25 previously reported cases. We report an additional example of primary thymic neuroblastoma in a previously asymptomatic 71-year-old man with an anterior mediastinal mass who underwent robotic excision with pericardium and adjacent lung. The tumor was a 5.2 cm partially encapsulated, white-tan and rubbery mass with grossly identifiable areas of necrosis (25%) and hemorrhage. Histologically, the specimen showed a rim of adipose tissue and residual thymic tissue with areas of cystic thymic epithelium and prominent lymphoid tissue containing Hassall's corpuscles. The tumor was composed of uniform, round cells with scant cytoplasm and small nuclei with inconspicuous nucleoli set within a background of conspicuous neuropil. Mitotic figures were easily found. By immunohistochemistry, the tumor cells expressed synaptophysin, chromogranin, NKX2.2 (diffuse, nuclear), GFAP (patchy), SMI31 (neurofilament) (focal, cytoplasmic), and TdT (diffuse, nuclear), while lacking expression of CD99, TTF-1, CK 20, MCPyV, PHOX2B, Olig2, OCT3/4, CD45, CD3 and PAX5. S100 protein was negative in the neuroblastic cells, with scattered positive cells in a vague sustentacular-like pattern. Fluorescence in situ hybridization for isochromosome 12p and EWSR1 gene rearrangement were negative. As thymic neuroblastoma is extremely rare in adults, a neuroblastic tumor of germ cell origin (either primary or metastatic) or spread from a sinonasal tract tumor should be excluded because of differing treatments and prognoses. The properties of these rare neoplasms appear similar to olfactory neuroblastoma rather than pediatric-type neuroblastoma.
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Affiliation(s)
- Katrina Collins
- Department of Pathology, Indiana University School of Medicine, 350 W 11th Street, Indianapolis, IN, 46202, USA.
| | - Thomas M Ulbright
- Department of Pathology, Indiana University School of Medicine, 350 W 11th Street, Indianapolis, IN, 46202, USA
| | - Jessica L Davis
- Department of Pathology, Indiana University School of Medicine, 350 W 11th Street, Indianapolis, IN, 46202, USA
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2
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Chaurasiya K, Kireeva E, Shamanskaya T, Kachanov D, Likar Y. Primary Neuroblastoma of the Thymus. Clin Nucl Med 2023; 48:e316-e317. [PMID: 37083676 DOI: 10.1097/rlu.0000000000004654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
ABSTRACT Primary neuroblastoma is the most common extracranial solid tumor in children and may occur anywhere along the sympathetic chain, but most commonly occur in abdominal/retroperitoneal region including the adrenal glands, followed by the thorax. In children, the most primary neuroblastomas in the thorax are in the posterior mediastinum. We present herein an extremely rare case of primary neuroblastoma of thymus in pediatric patient.
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Affiliation(s)
- Kailash Chaurasiya
- From the Department of Nuclear Medicine and PET/CT, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
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3
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Calabrese F, Fortarezza F, Pezzuto F, Lunardi F, Comacchio G, Sbaraglia M, Pasello G, Marulli G, Dei Tos AP, Rea F. The Rarest of Rare Thymic Lesions: A 10-Year Surgical Pathology Experience. Cancers (Basel) 2021; 13:4056. [PMID: 34439210 PMCID: PMC8392427 DOI: 10.3390/cancers13164056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022] Open
Abstract
The thymus is a specialized primary lymphoid organ located in the midline pre-vascular mediastinum. The organ is the site of various pathological processes, neoplastic and not, whose rarity has not allowed in-depth studies on clinical or histological features of rarest and unusual variants. Herein, we report a 10-year Padova experience in the surgical pathology of the thymus, focusing on the pathological description of nonneoplastic lesions and rare epithelial and mesenchymal tumors recorded in our database, which comprises over 600 thymectomies. The extrapolated rare cases have been categorized into four groups that included 15 cysts, 18 carcinomas, 5 neuroendocrine tumors, and 2 soft tissue tumors. The cases are described from a clinical and pathological point of view and discussed in dedicated sections with a review of the most important literature. In this case, review series, we aim to update the epidemiology of these rare entities, improve diagnostic awareness, and finally, promote a collaborative network between referral centers.
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Affiliation(s)
- Fiorella Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.F.); (F.P.); (F.L.); (G.C.); (F.R.)
| | - Francesco Fortarezza
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.F.); (F.P.); (F.L.); (G.C.); (F.R.)
| | - Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.F.); (F.P.); (F.L.); (G.C.); (F.R.)
| | - Francesca Lunardi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.F.); (F.P.); (F.L.); (G.C.); (F.R.)
| | - Giovanni Comacchio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.F.); (F.P.); (F.L.); (G.C.); (F.R.)
| | - Marta Sbaraglia
- Department of Medicine, University of Padova, 35121 Padova, Italy; (M.S.); (A.P.D.T.)
| | - Giulia Pasello
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, 35121 Padova, Italy;
| | - Giuseppe Marulli
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Angelo Paolo Dei Tos
- Department of Medicine, University of Padova, 35121 Padova, Italy; (M.S.); (A.P.D.T.)
| | - Federico Rea
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.F.); (F.P.); (F.L.); (G.C.); (F.R.)
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Kalaskar RR, Kalaskar AR. Neuroblastoma in early childhood: A rare case report and review of literature. Contemp Clin Dent 2016; 7:401-4. [PMID: 27630510 PMCID: PMC5004559 DOI: 10.4103/0976-237x.188579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Neuroblastoma is an extremely rare pediatric neoplasm whose prognosis becomes poor and poor as the age advances. It can be sporadic or nonfamilial in origin. It is primarily a tumor of abdominal origin from where it metastasis to lymph nodes, liver, intracranial and orbital sites, and central nervous system. There is no standard dental treatment protocol for the management of neuroblastoma due to its poor survival rate and rarity. However, dental treatment may follow the protocol of preventive and restorative. Surgicals should be performed under supervision as it may trigger metastasis. We report a rare case of neuroblastoma in a 3-year-old child presenting classical oral manifestations such as bilateral palatal swelling, rolled border ulcer on the posterior part of hard palate adjacent to primary molars, and bilateral proptosis.
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Affiliation(s)
- Ritesh R Kalaskar
- Department of Pedodontics, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Ashita R Kalaskar
- Department of Oral Diagnosis Medicine and Radiology, VSPM Dental College and Research Center, Nagpur, Maharashtra, India
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The 2015 World Health Organization Classification of Tumors of the Thymus: Continuity and Changes. J Thorac Oncol 2016; 10:1383-95. [PMID: 26295375 DOI: 10.1097/jto.0000000000000654] [Citation(s) in RCA: 370] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This overview of the 4th edition of the World Health Organization (WHO) Classification of thymic tumors has two aims. First, to comprehensively list the established and new tumor entities and variants that are described in the new WHO Classification of thymic epithelial tumors, germ cell tumors, lymphomas, dendritic cell and myeloid neoplasms, and soft-tissue tumors of the thymus and mediastinum; second, to highlight major differences in the new WHO Classification that result from the progress that has been made since the 3rd edition in 2004 at immunohistochemical, genetic and conceptual levels. Refined diagnostic criteria for type A, AB, B1-B3 thymomas and thymic squamous cell carcinoma are given, and it is hoped that these criteria will improve the reproducibility of the classification and its clinical relevance. The clinical perspective of the classification has been strengthened by involving experts from radiology, thoracic surgery, and oncology; by incorporating state-of-the-art positron emission tomography/computed tomography images; and by depicting prototypic cytological specimens. This makes the thymus section of the new WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart a valuable tool for pathologists, cytologists, and clinicians alike. The impact of the new WHO Classification on therapeutic decisions is exemplified in this overview for thymic epithelial tumors and mediastinal lymphomas, and future perspectives and challenges are discussed.
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Aramburu-Bodas Ó, Salamanca-Bautista P, Scocco S, Congregado-Loscertales M, Fernández-Díaz M, Cano-Guzmán M, López-Montesinos I, Ríos-Martín JJ, Runkle I. Resistant Hyponatremia Secondary to the Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Thymic Neuroblastoma. AACE Clin Case Rep 2016. [DOI: 10.4158/ep14542.cr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Wiesel O, Bhattacharyya S, Vaitkevicius H, Prasad S, McNamee C. Ataxia induced by a thymic neuroblastoma in the elderly patient. World J Surg Oncol 2015; 13:178. [PMID: 25962639 PMCID: PMC4491252 DOI: 10.1186/s12957-015-0594-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 04/24/2015] [Indexed: 11/10/2022] Open
Abstract
Thymic neuroblastoma is a rare tumor with only few reports in modern literature. Whereas most data is taken from childhood neuroblastoma, little is known about the characteristics of the disease in the adult and elderly population. There are significant differences between adult and childhood neuroblastoma which are reviewed below. We report a case of a 62-year-old male who presented with neurological symptoms of ataxia and opsoclonus and an anterior mediastinal mass. Ultimately, the patient underwent a resection of the mass and pathologic review identified a thymic neuroblastoma. This is the first case of thymic neuroblastoma associated with symptomatic central nervous system disease; it is presented with an up-to-date review of the previous cases in the field as well with a review of the literature of post adolescent neuroblastoma.
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Affiliation(s)
- Ory Wiesel
- Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA.
| | - Shamik Bhattacharyya
- Division of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA.
| | - Henrikas Vaitkevicius
- Division of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA.
| | - Sashank Prasad
- Division of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA.
| | - Ciaran McNamee
- Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA.
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Rogowitz E, Babiker HM, Kanaan M, Millius RA, Ringenberg QS, Bishop M. Neuroblastoma of the elderly, an oncologist's nightmare: case presentation, literature review and SEER database analysis. Exp Hematol Oncol 2014; 3:20. [PMID: 25071978 PMCID: PMC4112985 DOI: 10.1186/2162-3619-3-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/11/2014] [Indexed: 12/29/2022] Open
Abstract
Neuroblastoma is considered a pediatric malignancy as over 95% of cases are diagnosed in patients ≤10 years old. This cancer is extremely rare in elderly patients. We conducted a Surveillance, Epidemiology, and End Results (SEER) database analysis in the USA between 1973–2007 that revealed only 35 elderly patients (>60 years of age) with neuroblastoma of whom only 2 patients had primary mediastinal neuroblastoma. There is a paucity of treatment and survival outcomes data for the elderly owing to the rarity of neuroblastoma in this population. Currently there are no standard guidelines or protocols for treatment of adult neuroblastoma. We report a rare and challenging case of an 86-year old patient presenting with mediastinal neuroblastoma and syndrome of inappropriate antidiuretic hormone secretion (SIADH) successfully treated with resection. Herein, we also provide a review of the literature and updated survival data on neuroblastoma based on results of our SEER database review.
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Affiliation(s)
- Elisa Rogowitz
- University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724, USA.,Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723, USA
| | - Hani M Babiker
- Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723, USA.,Division of Hematology-Oncology, Department of Medicine, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, AZ 85724, USA.,Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724, USA
| | - Mohammed Kanaan
- Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723, USA.,Division of Hematology-Oncology, Department of Medicine, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, AZ 85724, USA.,Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724, USA
| | - Rebecca A Millius
- Department of Pathology, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, AZ 85724, USA
| | - Q Scott Ringenberg
- Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723, USA
| | - Maria Bishop
- Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723, USA.,Division of Hematology-Oncology, Department of Medicine, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, AZ 85724, USA.,Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724, USA
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