A large mediastinal benign myoepithelioma effacing the entire hemithorax: case report with literature review
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CASE REPORT
Open Access
A large mediastinal benign myoepithelioma effacing the entire hemithorax: case report with literature review Atif Ali Hashmi1,2,3, Amna Khurshid1,2,3, Naveen Faridi1,2,3, Muhammad Muzzammil Edhi1,2,3 and Mehmood Khan1,2,3*
Abstract Background: Myoepithelial neoplasms, although sometimes encountered in soft tissues are described very rarely in mediastinum and lung. We reported a rare case of such a tumor which was very large in size and not connected to respiratory tree. Case presentation: A 24 year old male presented with blunt chest pain and respiratory distress. A CT scan was performed which showed large heterogeneously enhancing soft tissue mass occupying the left hemithorax. It measures 18.5 X 15.8 X 7.6. Thoracotomy with excision of the tumor was done. Operative findings include multilobulated and nodular large glistening white tumor located in anterior mediastinum adherent to parietal pleura and effacing the pulmonary parenchyma. However tumor was not connected or seems to originate from trachea or lung. Microscopic sections show neoplastic lesion composed of nests, cords and trabeculae of small to medium sized cells with round nuclei and clear cytoplasm. Background showed myxoid appearance with areas of cartilaginous differentiation. Immunohistochemical expression of CKAE1/AE3, p63, ASMA, S100 and GFAP favored the diagnosis of benign myoepithelioma. Conclusion: Myoepithelial tumors are rare soft tissue tumors thought to arise from stem cells capable of divergent differentiation and occur anywhere in the body. Histopathologic recognition of these tumors is essential as these tumors may behave in a benign fashion despite large sizes. Keywords: Myoepithelioma, Benign mixed tumor, Mediastinum
Background Myoepithelial neoplasms are commonly encountered lesions of salivary glands and are rarely seen in soft tissues [1]. On the other hand myoepitheliomas are extremely rare in mediastinum [2]. A few case reports of benign mixed tumors described so far in mediastinum were thought to arise from ectopic salivary gland tissue along tracheobronchial tree and secondarily involved the mediastinum [3]. The term begin mixed tumor is used when there is ductular differentiation. On the other hand, myoepthelioma by definition don’t show obvious ductal differentiation. * Correspondence: [email protected] 1 Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan 2 Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan Full list of author information is available at the end of the article
Soft tissue myoepitheliomas are increasingly recognized tumors, formerly designated as parachordomas. They occur in all age groups and peak in 2nd to 4th decade of life. There is no significant gender predilection. They usually present with slowly growing painless mass in deep soft tissues of the extremities with head n neck and trunk being other sites involved in decreasing order of frequency.9 Grossly myoepitheliomas form nodular masses ranging in size
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