scholarly journals Ipilimumab and Pembrolizumab Mixed Response in a 41-Year-Old Patient with SMARCA4-Deficient Thoracic Sarcoma: An Interdisciplinary Case Study

2021 ◽  
pp. 706-715
Author(s):  
Nina Anžič ◽  
Fatime Krasniqi ◽  
Anna-Lena Eberhardt ◽  
Alexandar Tzankov ◽  
Jasmin Dionne Haslbauer
Keyword(s):  
Mediastinal Mass ◽  
Large Cell ◽  
Smoking History ◽  
Anterior Mediastinal Mass ◽  
Thoracic Pain ◽  
Mixed Response ◽  
Medical Evaluation ◽  
Individual Entity ◽  
Poorly Differentiated

SMARCA4-deficient thoracic sarcoma is a newly described entity of thoracic sarcomas with a poor prognosis, defined by poorly differentiated epithelioid to rhabdoid histomorphology and SMARCA4 gene inactivation. We present a case of a SMARCA4-deficient thoracic sarcoma in a 41-year-old male with a smoking history who presented with an upper anterior mediastinal mass, after seeking medical evaluation for increasing thoracic pain, odynophagia, and dizziness. The biopsy confirmed a large cell tumor with an epithelioid to rhabdoid histomorphology, positive for EMA, CD99, vimentin, TLE1, INI1, PAS-positive cytoplasmic granules, and PD-L1 (100% of tumor cells). High TMB and HRD scores were displayed in the tumor. The histology and immunophenotype of the mass were in line with the diagnosis of SMARCA4-deficient thoracic sarcoma. In the course of his treatment, the patient showcased a partial response to pembrolizumab and the combination of pembrolizumab and ipilimumab. This case report highlights the importance of recognizing SMARCA4-deficient thoracic sarcoma as an individual entity and supports the importance of checkpoint inhibition therapy for SMARCA4-deficient thoracic sarcomas, particularly in cases with a high TMB and PD-L1 expression.

Perioperative Anesthetic Management of Anterior Mediastinal Mass

2018 ◽  
pp. 53-57
Author(s):  
Alexandra Bastien
Keyword(s):  
Airway Management ◽  
Male Patient ◽  
Mediastinal Mass ◽  
Anesthetic Management ◽  
Preoperative Evaluation ◽  
Anterior Mediastinal Mass ◽  
Mechanical Effects ◽  
Life Threatening ◽  
Perioperative Course

Patients with an anterior mediastinal mass pose as anesthetic challenges for the unsuspecting anesthesiologist. They are fraught with potential life-threatening issues during the patient’s perioperative course secondary to both the disease state and the mechanical effects of these masses. Once discovered, anterior mediastinal masses should involve planning with experienced anesthesia personnel skilled at complex airway management and in dealing with intraoperative and postoperative emergent complications. This chapter uses a case study of a 45-year-old male patient presenting for preoperative evaluation for an anterior mediastinal mass biopsy via Chamberlain procedure to illustrate the concepts associated with perioperative anesthetic management of anterior mediastinal mass.

Anterior Mediastinal Paraganglioma Mimicking Thymoma

2012 ◽  
Vol 15 (3) ◽  
pp. 170
Author(s):  
Hee Moon Lee ◽  
Dong Seop Jeong ◽  
Pyo Won Park ◽  
Wook Sung Kim ◽  
Kiick Sung ◽  
...  
Keyword(s):  
Mediastinal Mass ◽  
Aortic Wall ◽  
Anterior Wall ◽  
Ascending Aorta ◽  
Anterior Mediastinal Mass ◽  
Arterial Reconstruction ◽  
Ct Evaluation ◽  
One Year ◽  
Mediastinal Paraganglioma

A 54-year-old man was referred to our institution with hemoptysis and hoarseness of 1 year's duration. A computed tomography (CT) scan showed an anterior mediastinal mass (2.5 cm x 1.0 cm), which was diagnosed as thymoma. The tumor was resected under a sternotomy. The tumor had invaded the anterior wall of the ascending aorta. With the patient under cardiopulmonary bypass, the aortic wall invaded by the mass was resected, and arterial reconstruction was performed with patch material. The tumor was revealed to be a tumor of neuronal origin. The patient's postoperative course was uneventful. The patient was discharged on postoperative day 9. One year after the operation, a follow-up chest CT evaluation showed no specific complications or recurrence.

scholarly journals A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ikuma Nozaki ◽  
Yumi Tone ◽  
Junko Yamanaka ◽  
Hideko Uryu ◽  
Yuko Shimizu-Motohashi ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Malignant Transformation ◽  
Poor Prognosis ◽  
Mediastinal Mass ◽  
Bone Biopsy ◽  
Systematic Evaluation ◽  
Anterior Mediastinal Mass ◽  
Malignant Teratoma ◽  
Experienced Pain

We report about a 14-year-old boy who presented with an anterior mediastinal mass that was diagnosed as malignant teratoma. Surgical resection was performed along with pre- and postoperative chemotherapy. Although elevated alpha-fetoprotein became negative, he experienced pain in his right hip joint 3 months after resection. Systematic evaluation revealed multiple locations of metastasis, and the pathological diagnosis based on bone biopsy was malignant melanoma originating from malignant teratoma, which rapidly progressed. He died 15 months after diagnosis of the original malignant teratoma. Diagnosing and treating malignant transformation of teratoma, including malignant melanoma, is difficult because it is very rare. To our knowledge, this is the second reported case of malignant melanoma arising from a mediastinum malignant teratoma, with both cases having a poor prognosis. In addition to the follow-up of tumor markers, systematic evaluation, including imaging, should be considered even after remission to monitor malignant transformation of teratoma. We expect to establish a successful therapy and improve mortality rate after more such cases are accumulated.

scholarly journals Transient maintenance of tracheal patency upon the insertion of a flexible bronchoscope in a patient with an anterior mediastinal mass: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takayuki Hasegawa ◽  
Shinju Obara ◽  
Rieko Oishi ◽  
Satsuki Shirota ◽  
Jun Honda ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Mediastinal Mass ◽  
Balloon Dilation ◽  
Maximum Flow ◽  
Anterior Mediastinal Mass ◽  
Positive Pressure ◽  
Anesthesia Induction ◽  
Flexible Bronchoscope ◽  
Case Presentation ◽  
Tracheal Collapse

Abstract Background Patients with an anterior mediastinal mass are at risk of perioperative respiratory collapse. Case presentation A 74-year-old woman with a large anterior mediastinal mass that led to partial tracheal collapse (shortest diameter, 1.3 mm) was scheduled for tracheobronchial balloon dilation and stent placement under general anesthesia. Although veno-venous extracorporeal membrane oxygenation (V-V ECMO) had been established, maximum flow was limited to 1.6 L/min, and general anesthesia induction was followed by hypoxia probably due to inadequate ventilation. A flexible bronchoscope was inserted through the tracheal lumen that was being compressed by the anterior mass; this not only increased tracheal patency but also enabled positive pressure ventilation and resulted in recovery from hypoxia. Scheduled procedures were successfully performed without complications. Conclusion We describe a case wherein tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with an anterior mediastinal mass.

Micronodular Thymoma With Lymphoid Stroma: A Trio of Cases, With Diverse-associated Histological Features

2021 ◽  
pp. 106689692110011
Author(s):  
Neha Bakshi ◽  
Shashi Dhawan ◽  
Seema Rao ◽  
Kishan Singh Rawat
Keyword(s):  
Mediastinal Mass ◽  
Single Case ◽  
Case Reports ◽  
Good Prognosis ◽  
Anterior Mediastinal Mass ◽  
Histological Features ◽  
Lymphoid Stroma ◽  
Thymic Cysts ◽  
Robotic Thymectomy ◽  
Conventional Type

Introduction. Micronodular thymoma with lymphoid stroma (MNTLS) is a rare thymoma subtype characterized by distinctive histological appearance, unique clinical profile, and indolent course with good prognosis. In addition to its distinctive morphology, MNTLS may be associated with diverse histological features, such as thymic cysts and conventional thymoma, complicating the diagnostic picture further. Materials and methods. We report herein an account of 3 elderly patients (male—02; female—01), who presented with anterior mediastinal mass, and underwent robotic thymectomy. Microscopic examination revealed MNTLS in all 3 cases. In addition, 2 cases showed associated histological features in the form of a multilocular thymic cyst and conventional (type B2) thymoma, respectively. All 3 patients are doing well without recurrence or metastasis at 34, 28, and 19 months postsurgery. Conclusions. Awareness of this rare thymoma subtype is vital among pathologists to avoid misdiagnosis and ensure appropriate patient management. To date, only a few cases of this rare thymoma subtype have been reported in the literature, mostly as single case reports.

scholarly journals Infantile myofibromatosis presenting as a bilobed abdominal and anterior mediastinal mass: Resection via clam-shell incision

2021 ◽  
Vol 68 ◽  
pp. 101829
Author(s):  
Abdurrahman Mirza ◽  
Ameera Almatrfi ◽  
Khalid Rasheed ◽  
Soliman Binyahib ◽  
Imran Saeed
Keyword(s):  
Mediastinal Mass ◽  
Anterior Mediastinal Mass ◽  
Infantile Myofibromatosis ◽  
Clam Shell

scholarly journals The Prevalence of Carotid Artery Calcification on the Panoramic Radiographs in Cappadocia Region Population

2007 ◽  
Vol 01 (03) ◽  
pp. 132-138 ◽  
Author(s):  
Yildiray Sisman ◽  
Elif Tarim Ertas ◽  
Cumali Gokce ◽  
Ahmed Menku ◽  
Mustafa Ulker ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Turkish Population ◽  
Smoking History ◽  
Panoramic Radiographs ◽  
Carotid Artery Calcification ◽  
Medical Evaluation ◽  
Life Saving ◽  
Males And Females ◽  
School Of Dentistry ◽  
And Gender

ABSTRACTObjectives: The aim of this study is to determine retrospectively the presence of carotid artery calcifications (CACs) detected on panoramic radiographs (PRs) in a group of Turkish population. Further, the relationships between CACs and gender, life style, and medical history were evaluated.Methods:During the years 2004 to 2006, a random sample of 1282 PRs was collected from patients older than 40 years who were being treated by the School of Dentistry, Erciyes University. Of these 1282 PRs, 750 PRs were included in this study. Medical data was collected from the archival records of the dental school.Results: About 38 (5.06%) CACs were found on the PRs of 12 (4.5%) males and 26 (5.4%) females. The CAC prevalence was not significantly different between the males and females (P=0.583). These calcifications were unilateral in 26 (68.4%) and bilateral in 12 (31.6%) subjects. Of those in the positive group, there were 12 subjects (31.58%) with hyperlipidemia, 12 subjects (31.58%) with hypertension, 7 subjects (18.4%) with diabetes mellitus, 6 subjects (15.8%) with cardiovascular disease, and 6 subjects (15.8%) with smoking history.Conclusions: This study has the highest CACs prevalence in comparison to the other studies. Therefore, dentists caring for subjects with dental problems should carefully evaluate their PRs for the evidence of CACs, and refer them for medical evaluation as indicated. So, incidental findings could provide life-saving information. (Eur J Dent 2007;1:132-138)

Introducing Problem-based Learning to Special Needs Dentistry—A Case Study

2002 ◽  
Vol os9 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Raman Bedi ◽  
Jackie A Champion ◽  
Roger Davies
Keyword(s):  
Special Needs ◽  
Problem Based Learning ◽  
Chi Square ◽  
Training And Education ◽  
Mixed Response ◽  
Conventional Teaching ◽  
The Subject ◽  
Better Than ◽  
Made In

Introduction In order to promote training and education in special-needs dentistry an attempt was made to introduce problem-based learning (PBL) as a method of postgraduate dental education. The aim of this paper was to review the principles of PBL and report on a case study using this methodology. Method The case study was of a PBL session, on the subject of ‘problems of obtaining appropriate dental care for people with epilepsy’, undertaken at a national conference. Delegates were asked to complete a pre- and post-session questionnaire on PBL and their attitudes to the session. Results The session received a mixed response. Only 33 (35%) thought the session was valuable and only 20 (31%) thought it was better than conventional teaching methods and yet over half (55%) said they would like to attend more PBL in special-needs dentistry. Professionals complementary to dentistry were more likely to find the PBL session of value and to prefer the method to a more conventional format than dentists were (chi-square=5.5, df=1, p<0.05 and chi-square=5.9, df=1, p<0.05 respectively). Conclusion Valuable feedback was received from delegates. This will enable improvements to be made in future courses so that the effectiveness of PBL can be optimised.

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