A 58-year-old man, who had undergone right hepatic lobectomy for hepatocellular carcinoma 6 years before, complained of hoarseness because of right recurrent laryngeal nerve paralysis. Chest X-ray film showed a large mass shadow in the superior mediastinum. On chest CT scan the mass was considered to be swollen paratracheal lymph nodes. Percutaneous aspiration biopsy of the mass demonstrated malignant epithelial cells. It was suspected that the hepatocellular carcinoma solitarily metastasized to the paratracheal lymph nodes. Right thoracotomy was done and the mediastinal tumor was resected. Microscopic examination of the resected specimen proved that the tumor was a metastatic hepatocellular carcinoma not of the lymph nodes, but of the fibroadipose tissue of the mediastinum. Metastasis of hepatocellular carcinoma to the mediastinal fibroadipose tissue is uncommon. To our knowledge, our case is the first report of hepatocellular carcinoma which shows such a metastasis.

Carcinoma, Hepatocellular↗

PubMed1992

[A case of subclavian paraganglioma in the superior mediastinum extending to the neck].

A 52-year-old female was admitted to our hospital with left anterior chest pain. On physical examination, an elastic hard mass sized in 3.0 x 2.5 cm was palpable at the left suprasternal area. Chest X-ray film showed a large mass shadow in the cervico-thoracic region, and CT films revealed a well-defined mass in the superior mediastinum which was heterogeneously enhanced by contrast medium. Operation was performed under the preoperative diagnosis of thymic tumor extending upwards. At operation, the tumor was located between the trachea and the left subclavian artery in the superior mediastinum displacing these structures and extending to the neck. Resected specimen which was 5.5 x 3.5 x 3.0 cm in size and 42 gm in weight was well encapsulated and highly vascularized. On microscopic findings, the tumor was finally diagnosed as paraganglioma. According to the classification of Glenner and Grimley, it was thought that the tumor originated from subclavian paraganglion in the superior mediastinum. Subclavian paraganglioma had rarely been reported in the literatures. As subclavian paraganglioma, our patient was the first reported case in Japan.

Female↗

PubMed1992

[A case of hemangioma of the small intestine diagnosed by angiography].

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Adult↗

PubMed1989

[Histochemical study on glutathione S-transferase in patients with testicular tumor].

Tumor tissue and nontumorous tissue of 31 patients with testicular tumor were examined by the peroxidase antiperoxidase (PAP) procedure using the primary antibody against glutathione S-transferase (GST). Histology of primary tumor was classified as seminoma in 10 cases, non-seminoma in 18 (including 2 cases of yolk sac tumor), and malignant lymphoma in 3. Tumorous tissues except one with yolk sac tumor failed to be stained with GST. The seminiferous tubules of the nontumorous testicular tissue had a positive reaction in the infant cases, but not in the adult cases. The degenerated seminiferous tubules involved in the testicular tumors also had a positive reaction in all the cases. Leydig cells had a positive reaction in all the cases. In particular, diffuse Leydig cell's hyperplasia was observed in a case with high serum beta hCG and urinary hCG levels. These data may be relevant in explaining the inherent hypofertility of these patients.

Adult↗

PubMed1989

[A case of dumb-bell-like neurilemmoma of the posterior mediastinum].

A 56 year-old female was pointed out an abnormal shadow on chest X-ray film for the lung cancer screening study. Chest X-ray film showed a round mass shadow at the right superior mediastinum. Chest CT scan revealed the mass was in the paravertebral area abutting on the 2nd thoracic vertebral body and had extended into the intervertebral foramen. Preoperative diagnosis was a dumb-bell-like neurogenic tumor. Operation was carried out by posterior approach in the prone position. At first thoracotomy was done by removing the paravertebral portion of the 2nd and 3rd ribs, and then hemilaminectomy was added. Both the intrathoracic and intraforminal portions of the tumor were completely exposed, and excised. Pathological examination demonstrated the tumor was a typical neurilemmoma originating from the 2nd intercostal nerve. When a neurogenic tumor of the posterior mediastinum has an intraspinal extension, a posterior approach by a simultaneous thoracotomy and laminectomy will be useful to remove the tumor at one sitting.

Female↗

PubMed1988