Mediastinal malign fibröz histiyositoma: Olgu sunumu

Mediastinal malign tümörler göğüs cerrahisinde seyrek görülmelerine rağmen tedavilerindeki yaklaşım ilkeleri açısından önemli hastalıklardır. Hastanemiz göğüs hastalıkları kliniğine başvuran 55 yaşında bayan hastanın yapılan tetkiklerinde mediasten invazyonu gösteren kitle saptandı. Transtorasik biyopsiden sonuç alınamayınca kliniğimize sevkedildi. Hastaya keşif amaçlı torakotomi uygulandı. Sağ hemitoraksın 2/3'ünü dolduran kitleye total eksizyon uygulandı. Patoloji sonucu malign fibröz histiyositoma olarak rapor edildi. Malign mezenkimal tümörler, karsinomlardan farklı olarak komşu organ invazyonunu daha geç oluşturmaktadır. Preoperatif değerlendirme bazen yanıltıcı olabilmektedir. Bu nedenle intratorasik malign mezenkimal tümörlerde hastalara cerrahi şans tanınmalıdır.

Mediastinal malignant fibrous histyocytoma

Malign neoplasms of mediastinum are important diseases even they are observed rarely. A female patient aged 55 who applied to pneumology department of our hospital was examined and found out a giant mass which invaded mediastinum. Transthoracic needle aspiration biopsy revealed no result. Explorative thoracotomy was performed. A giant mass which filled approximately 2/3 of right hemithorax was exised totally. Pathologic examination was reported as malign fibrous histyocytoma. Malign mesenchimal neoplasms invade adjacent structures later than carcinomas. Preoperative evoluation sometimes may be misleading. For this reason, a chance of surgical resection to these patients with intrathoracic mesenchimal neoplasms must be given.

PDF

___

1) . Arıbaş OK, Görmüş N. Obstructing endobronchial malignant fibrous histiocytoma. Eur J Cardiothorac Surg 2001;19:716-8.
2) Athanassiadi K, Kalavrouziotis G, Rondogianni D Loutsidis A, Hatzimichalis A, Bellenis I. Primary chest wall tumors: Early and long-term results of surgical treatment. Eur J Cardiothorac Surg 2001;19:589-93.
3) Trupiano JK, Rice TW, Herzog K, at al. Mediastinal synovial sarcoma: Report of two cases with molecular genetic analysis. Ann Thorac Surg 2002;73:628-30.
4) Bacha EA, Chapelier AR, Macchiarini P, Fadel E, Dartevelle PG. Surgery for invasive primary mediastinal tumors. Ann Thorac Surg 1988;66:234-9.
5) Etienne-Mastroianni B, Falchero L, Chalabreysse L, et al. Primary sarcomas of the lung. A clinicopathologic study of 12 cases. Lung Cancer 2002;38:283-9.
6) Alhabad T, Alvarez F, Phillips NJ, Hauptman PJ. Malignant fibrous histiocytoma of the lung presenting as bronchial obstruction in a heart transplant reciepent. J Heart Lung Transplant 2002;21:1140-3.