A Patient with aThoracic Tumefation
,
Abstract
Tumors of the chest wall are uncommon lesions that comprise a heterogeneous group of neoplasms. These tumors may arise from osseous structures or soft tissues and may be malignant or benign. We describe the case of a proliferative swelling of uncertain origin that led us to suspect a neuroendocrine origin for the mass we observed and studied. Neuroendocrine tumors arise from neuroendocrine cells, which are peptide- and amine-producing cells dispersed throughout the body. Usually, these tumors occur in various organs as intrathoracic or abdominal masses that become manifest after a variable time, usually after inducing a heterogeneous symptomatology secondary to the secretion of various molecules. The case we describe, on the other hand, develops both exophytically and endophytically, first appearing as an externally developing thoracic mass. Subsequent appropriate investigations revealed bone and muscle involvement in the patient’s thoracic cavity. Therefore, we describe our management of a paucisymptomatic patient who presented with a rapidly developing swelling in the intermammary site that progressed equally rapidly.
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[3]Lupon E, Lellouch AG, Deilhes F, et al. Reconstruction of a dorsal thoracic wall defect with a dorsal intercostal artery perforator flap after removal of a bulky cutaneous squamous cell carcinoma: a case report. J Med Case Rep. 2019 Sep 17;13(1):294. https://doi.org/10.1186/s13256-019-2226-1
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[5]Yan F Jin X, Zhang XH, et al. Chest CT Findings of Primary Neuroendocrine Tumor of Thymus:Analysis of 7 Cases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Aug 30;40(4):468-472.
[6]Gao J, Chow E, Aloma A, et al. Peripheral primitive neuroendocrine tumor of the chest wall-A case report with pathological correlation. Radiol Case Rep. 2018 Feb 5;13(2):392-396. https://doi.org/10.1016/j.rad-cr.2018.01.003
[7]Al-Ayoubi AM, Ralston JS, Richardson SR, et al. Diffuse pulmonary neuroendocrine cell hyperplasia involving
the chest wall. Ann Thorac Surg. 2014 Jan;97(1):333-5. https://doi.org/10.1016/j.athoracsur.2013.04.139
[8]Cipriano A, Burfeind W Jr. Management of Primary Soft Tissue Tumors of the Chest Wall. Thorac Surg Clin. 2017 May;27(2):139-147. https://doi.org/10.1016/j.thorsurg.2017.01.007
[9]Coode PE, McGuinness FE, Rawas MM, et al. Diffuse lipomatosis involving the thoracic and abdominal wall: CT features. J Comput Assist Tomogr. 1991 Mar-Apr;15(2):341-3. https://doi.org/10.1097/00004728-199103000-00034
[10]Klöppel G. Neuroendocrine neoplasms : Two families with distinct features unified in one classification. Pathologe.
2019 May;40(3):211-219. https://doi.org/10.1007/s00292-019-0594-3
[11]Rindi G, Klimstra DS, Abedi-Ardekani B, et al. A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod Pathol. 2018 Dec;31(12):1770-1786. https://doi.org/10.1038/s41379-018-0110-y Massimo Magro V, et al. A Thoracic Tumefation, CRCP. 2023; 8(3):94-100
[12]Blank A, Schmitt A, Perren A. Pathology: Classification and Immunoprofile. Front Horm Res. 2015;44:104-14. https://doi.org/10.1159/000382135
[13]Białecki M, Białecka A, Męcińska-Jundziłł K, et al. Imaging in a rare case of neuroendocrine tumour with skin metastases. Pol J Radiol. 2018 Feb 4;83:e63-e67. https://doi. org/10.5114/pjr.2018.73307
[14]Dasari A, Shen C, Halperin D, et al. Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States. JAMA Oncol. 2017 Oct; 3(10): 1335-1342. https://doi. org/10.1001/jamaoncol.2017.0589
[15]Cives M, Strosberg JR. Gastroenteropancreatic Neuroen- docrine Tumors. CA Cancer J Clin. 2018 Nov;68(6):471-487. https://doi.org/10.3322/caac.21493
[16]Uruga H, Mino-Kenudson M. Lung neuroendocrine tumors: a new addition to the evolving list of spread through air spaces. Transl Lung Cancer Res. 2019 Dec;8(Suppl 4):S443-S446. https://doi.org/10.21037/tlcr.2019.09.03
[17] Asioli S, Foschini MP, Masetti R, et al. Working formulation of neuroendocrine tumors of the skin and breast. Endocr Pathol. 2014 Jun;25(2):141-50. https://doi.org/10.1007/ s12022-014-9319-6
[18] Bellizzi AM. Assigning site of origin in metastatic neu- roendocrine neoplasms: a clinically significant appli- cation of diagnostic immunohistochemistry. Adv Anat Pathol. 2013 Sep;20(5):285-314. https://doi.org/10.1097/ PAP.0b013e3182a2dc67
[19] Baloch ZW, LiVolsi VA. Neuroendocrine tumors of the thy- roid gland. Am J Clin Pathol. 2001 Jun;115 Suppl:S56-67. https://doi.org/10.1309/7NK9-VUAL-9WU2-KJ19
[20] Hofland J, Zandee WT, de Herder WW. Role of biomark- er tests for diagnosis of neuroendocrine tumours. Nat Rev Endocrinol. 2018 Nov;14(11):656-669. https://doi. org/10.1038/s41574-018-0082-5
[21] Oronsky B, Ma PC, Morgensztern D, et al. Nothing But NET: A Review of Neuroendocrine Tumors and Carcino- mas. Neoplasia. 2017 Dec;19(12):991-1002. https://doi. org/10.1016/j.neo.2017.09.002
[22] Singh A, Hines JJ, Friedman B. Multimodality Imaging of the Pancreatic Neuroendocrine Tumors. Semin Ul- trasound CT MR. 2019 Dec;40(6):469-482. https://doi. org/10.1053/j.sult.2019.04.005
[23] Sanli Y, Garg I, Kandathil A, et al. Neuroendocrine Tumor Diagnosis and Management: 68Ga-DOTATATE PET/CT. AJR Am J Roentgenol. 2018 Aug;211(2):267-277. https:// doi.org/10.2214/AJR.18.19881
[24]Bergeret S, Charbit J, Ansquer C, et al. Novel PET tracers: added value for endocrine disorders. Endocrine. 2019 Apr; 64(1):14-30. https://doi.org/10.1007/s12020-019-01895-z
[25] Gupta S, Gupta P, Rohilla M, et al. Neuroendocrine car- cinomas: Cytological mimics and diagnostic dilemmas. Diagn Cytopathol. 2020 Jan 24. doi: 10.1002/dc.24386. https://doi.org/10.1002/dc.24386
[26] Nicholson SA, Ryan MR. A review of cytologic findings in neuroendocrine carcinomas including carcinoid tumors with histologic correlation. Cancer. 2000 Jun 25;90(3):148- 61. https://doi.org/10.1002/1097-0142(20000625)90:3<1 48::AID-CNCR3>3.0.CO;2-9
[27] Selves J, Long-Mira E, Mathieu M-C, et al. Immunohis- tochemistry for Diagnosis of Metastatic Carcinomas of Unknown Primary Site. Cancers (Basel) 2018 Apr; 10(4): 108. https://doi.org/10.3390/cancers10040108
[28] Jürgen C. Becker, Andreas Stang, et al. Merkel cell car- cinoma. Nat Rev Dis Primers. 2017 Oct 26; 3: 17077. https://doi.org/10.1038/nrdp.2017.77
[29] Lin F, Liu H. Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. Arch Pathol Lab Med. 2014 Dec;138(12):1583-610. https://doi.org/10.5858/ar- pa.2014-0061-RA
[30] Wahba OM. The diagnostic utility of pan-cytokera- tin, CK19, CEA, CD10, and p63 in differentiating clear cell odontogenic carcinoma from hyalinizing clear cell carcinoma. Tanta Dent J 2016;13:73-82. https://doi. org/10.4103/1687-8574.188907
[31] Chu PG, Weiss LM. Keratin expression in human tissues and neoplasms. Histopathology 2002; 40:403-439. https:// doi.org/10.1046/j.1365-2559.2002.01387.x
[32] Al Haddabi I, Al Bahri M, Burney I. Cytokeratin-posi- tive primitive neuroectodermal tumor of the prostate: Case report and review of literature. Indian J Pathol Mi- crobiol 2012;55:569-71. https://doi.org/10.4103/0377- 4929.107826
[33] Yoo S-H, Han J, Kim TJ, et al. Expression of CD99 in Pleomorphic Carcinomas of the Lung. J Korean Med Sci. 2005 Feb; 20(1): 50-55. https://doi.org/10.3346/ jkms.2005.20.1.50
[34] De Feo A, Sciandra M, Ferracin M, et al. Exosomes from CD99-deprived Ewing sarcoma cells reverse tumor ma- lignancy by inhibiting cell migration and promoting neural differentiation. Cell Death Dis. 2019 Jun 17;10(7):471. https://doi.org/10.1038/s41419-019-1675-1
[35] Zhou X, Huang X, Huang Z, et al. CD99 regulates rediffer- entiation of classical Hodgkin’s lymphoma cell line L428 towards B cells. Nan Fang Yi Ke Da Xue Xue Bao. 2013 Feb;33(2):235-8.
[36] Russell PA, Rogers TM, Solomon B, et al. Correlation between molecular analysis, diagnosis according to the 2015 WHO classification of unresected lung tumours and TTF1 expression in small biopsies and cytology specimens from 344 non-small cell lung carcinoma pa- tients. Pathology. 2017 Oct;49(6):604-610. https://doi. org/10.1016/j.pathol.2017.07.002
[37] Chen C, Shen D, Li J, et al. TTF-1 and EGFR expression are related to EGFR mutation in lung adenocarcinoma. Int J Clin Exp Pathol. 2018 Sep 1;11(9):4650-4656.
[38] Yap LW, Brok J, Pritchard-Jones K. Role of CD56 in Nor- mal Kidney Development and Wilms Tumorigenesis. Fetal Pediatr Pathol. 2017 Feb;36(1):62-75. https://doi.org/10.1 080/15513815.2016.1256358
[39] Wang H, Ma C, Wu J, et al. Clinicopathologic features of the ureteral neuroendocrine tumors. Pathol Res Pract. 2020 Feb;216(2):152788. https://doi.org/10.1016/j. prp.2019.152788[40] Becker JC, Stang A, DeCaprio JA, et al. Merkel cell carcinoma. Nat Rev Dis Primers. 3: 17077. https://doi.org/10.1038/nrdp.2017.77
[41] Sandri A, Donati G, Blanc CD, et al. Anterior chest wall resection and sternal body wedge for primary chest wall tumour: reconstruction technique with biological meshes and titanium plates. J Thorac Dis. 2020 Jan;12(1):17-21. https://doi.org/10.21037/jtd.2019.06.45
[42] Rinke A, Gress TM. Neuroendocrine Cancer, Therapeutic Strategies in G3 Cancers. Digestion. 2017;95(2):109-114. https://doi.org/10.1159/000454761
[43] Lo Russo G, Pusceddu S, Proto C, et al. Treatment of lung large cell neuroendocrine carcinoma. Tumour Biol. 2016 Jun;37(6):7047-57. https://doi.org/10.1007/s13277- 016-5003-4
[2]Shin YS, Choi CH, Kim YJ, et al. Primary squamous cell carcinoma in the chest wall mimicking abscess. J Thorac Dis. 2015 Jul;7(7):E179-81.
[3]Lupon E, Lellouch AG, Deilhes F, et al. Reconstruction of a dorsal thoracic wall defect with a dorsal intercostal artery perforator flap after removal of a bulky cutaneous squamous cell carcinoma: a case report. J Med Case Rep. 2019 Sep 17;13(1):294. https://doi.org/10.1186/s13256-019-2226-1
[4]Thomas M, Shen KR. Primary Tumors of the Osseous Chest Wall and Their Management. Thorac Surg Clin. 2017 May;27(2):181-193. https://doi.org/10.1016/j.thorsurg.2017.01.012
[5]Yan F Jin X, Zhang XH, et al. Chest CT Findings of Primary Neuroendocrine Tumor of Thymus:Analysis of 7 Cases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Aug 30;40(4):468-472.
[6]Gao J, Chow E, Aloma A, et al. Peripheral primitive neuroendocrine tumor of the chest wall-A case report with pathological correlation. Radiol Case Rep. 2018 Feb 5;13(2):392-396. https://doi.org/10.1016/j.rad-cr.2018.01.003
[7]Al-Ayoubi AM, Ralston JS, Richardson SR, et al. Diffuse pulmonary neuroendocrine cell hyperplasia involving
the chest wall. Ann Thorac Surg. 2014 Jan;97(1):333-5. https://doi.org/10.1016/j.athoracsur.2013.04.139
[8]Cipriano A, Burfeind W Jr. Management of Primary Soft Tissue Tumors of the Chest Wall. Thorac Surg Clin. 2017 May;27(2):139-147. https://doi.org/10.1016/j.thorsurg.2017.01.007
[9]Coode PE, McGuinness FE, Rawas MM, et al. Diffuse lipomatosis involving the thoracic and abdominal wall: CT features. J Comput Assist Tomogr. 1991 Mar-Apr;15(2):341-3. https://doi.org/10.1097/00004728-199103000-00034
[10]Klöppel G. Neuroendocrine neoplasms : Two families with distinct features unified in one classification. Pathologe.
2019 May;40(3):211-219. https://doi.org/10.1007/s00292-019-0594-3
[11]Rindi G, Klimstra DS, Abedi-Ardekani B, et al. A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod Pathol. 2018 Dec;31(12):1770-1786. https://doi.org/10.1038/s41379-018-0110-y Massimo Magro V, et al. A Thoracic Tumefation, CRCP. 2023; 8(3):94-100
[12]Blank A, Schmitt A, Perren A. Pathology: Classification and Immunoprofile. Front Horm Res. 2015;44:104-14. https://doi.org/10.1159/000382135
[13]Białecki M, Białecka A, Męcińska-Jundziłł K, et al. Imaging in a rare case of neuroendocrine tumour with skin metastases. Pol J Radiol. 2018 Feb 4;83:e63-e67. https://doi. org/10.5114/pjr.2018.73307
[14]Dasari A, Shen C, Halperin D, et al. Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States. JAMA Oncol. 2017 Oct; 3(10): 1335-1342. https://doi. org/10.1001/jamaoncol.2017.0589
[15]Cives M, Strosberg JR. Gastroenteropancreatic Neuroen- docrine Tumors. CA Cancer J Clin. 2018 Nov;68(6):471-487. https://doi.org/10.3322/caac.21493
[16]Uruga H, Mino-Kenudson M. Lung neuroendocrine tumors: a new addition to the evolving list of spread through air spaces. Transl Lung Cancer Res. 2019 Dec;8(Suppl 4):S443-S446. https://doi.org/10.21037/tlcr.2019.09.03
[17] Asioli S, Foschini MP, Masetti R, et al. Working formulation of neuroendocrine tumors of the skin and breast. Endocr Pathol. 2014 Jun;25(2):141-50. https://doi.org/10.1007/ s12022-014-9319-6
[18] Bellizzi AM. Assigning site of origin in metastatic neu- roendocrine neoplasms: a clinically significant appli- cation of diagnostic immunohistochemistry. Adv Anat Pathol. 2013 Sep;20(5):285-314. https://doi.org/10.1097/ PAP.0b013e3182a2dc67
[19] Baloch ZW, LiVolsi VA. Neuroendocrine tumors of the thy- roid gland. Am J Clin Pathol. 2001 Jun;115 Suppl:S56-67. https://doi.org/10.1309/7NK9-VUAL-9WU2-KJ19
[20] Hofland J, Zandee WT, de Herder WW. Role of biomark- er tests for diagnosis of neuroendocrine tumours. Nat Rev Endocrinol. 2018 Nov;14(11):656-669. https://doi. org/10.1038/s41574-018-0082-5
[21] Oronsky B, Ma PC, Morgensztern D, et al. Nothing But NET: A Review of Neuroendocrine Tumors and Carcino- mas. Neoplasia. 2017 Dec;19(12):991-1002. https://doi. org/10.1016/j.neo.2017.09.002
[22] Singh A, Hines JJ, Friedman B. Multimodality Imaging of the Pancreatic Neuroendocrine Tumors. Semin Ul- trasound CT MR. 2019 Dec;40(6):469-482. https://doi. org/10.1053/j.sult.2019.04.005
[23] Sanli Y, Garg I, Kandathil A, et al. Neuroendocrine Tumor Diagnosis and Management: 68Ga-DOTATATE PET/CT. AJR Am J Roentgenol. 2018 Aug;211(2):267-277. https:// doi.org/10.2214/AJR.18.19881
[24]Bergeret S, Charbit J, Ansquer C, et al. Novel PET tracers: added value for endocrine disorders. Endocrine. 2019 Apr; 64(1):14-30. https://doi.org/10.1007/s12020-019-01895-z
[25] Gupta S, Gupta P, Rohilla M, et al. Neuroendocrine car- cinomas: Cytological mimics and diagnostic dilemmas. Diagn Cytopathol. 2020 Jan 24. doi: 10.1002/dc.24386. https://doi.org/10.1002/dc.24386
[26] Nicholson SA, Ryan MR. A review of cytologic findings in neuroendocrine carcinomas including carcinoid tumors with histologic correlation. Cancer. 2000 Jun 25;90(3):148- 61. https://doi.org/10.1002/1097-0142(20000625)90:3<1 48::AID-CNCR3>3.0.CO;2-9
[27] Selves J, Long-Mira E, Mathieu M-C, et al. Immunohis- tochemistry for Diagnosis of Metastatic Carcinomas of Unknown Primary Site. Cancers (Basel) 2018 Apr; 10(4): 108. https://doi.org/10.3390/cancers10040108
[28] Jürgen C. Becker, Andreas Stang, et al. Merkel cell car- cinoma. Nat Rev Dis Primers. 2017 Oct 26; 3: 17077. https://doi.org/10.1038/nrdp.2017.77
[29] Lin F, Liu H. Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. Arch Pathol Lab Med. 2014 Dec;138(12):1583-610. https://doi.org/10.5858/ar- pa.2014-0061-RA
[30] Wahba OM. The diagnostic utility of pan-cytokera- tin, CK19, CEA, CD10, and p63 in differentiating clear cell odontogenic carcinoma from hyalinizing clear cell carcinoma. Tanta Dent J 2016;13:73-82. https://doi. org/10.4103/1687-8574.188907
[31] Chu PG, Weiss LM. Keratin expression in human tissues and neoplasms. Histopathology 2002; 40:403-439. https:// doi.org/10.1046/j.1365-2559.2002.01387.x
[32] Al Haddabi I, Al Bahri M, Burney I. Cytokeratin-posi- tive primitive neuroectodermal tumor of the prostate: Case report and review of literature. Indian J Pathol Mi- crobiol 2012;55:569-71. https://doi.org/10.4103/0377- 4929.107826
[33] Yoo S-H, Han J, Kim TJ, et al. Expression of CD99 in Pleomorphic Carcinomas of the Lung. J Korean Med Sci. 2005 Feb; 20(1): 50-55. https://doi.org/10.3346/ jkms.2005.20.1.50
[34] De Feo A, Sciandra M, Ferracin M, et al. Exosomes from CD99-deprived Ewing sarcoma cells reverse tumor ma- lignancy by inhibiting cell migration and promoting neural differentiation. Cell Death Dis. 2019 Jun 17;10(7):471. https://doi.org/10.1038/s41419-019-1675-1
[35] Zhou X, Huang X, Huang Z, et al. CD99 regulates rediffer- entiation of classical Hodgkin’s lymphoma cell line L428 towards B cells. Nan Fang Yi Ke Da Xue Xue Bao. 2013 Feb;33(2):235-8.
[36] Russell PA, Rogers TM, Solomon B, et al. Correlation between molecular analysis, diagnosis according to the 2015 WHO classification of unresected lung tumours and TTF1 expression in small biopsies and cytology specimens from 344 non-small cell lung carcinoma pa- tients. Pathology. 2017 Oct;49(6):604-610. https://doi. org/10.1016/j.pathol.2017.07.002
[37] Chen C, Shen D, Li J, et al. TTF-1 and EGFR expression are related to EGFR mutation in lung adenocarcinoma. Int J Clin Exp Pathol. 2018 Sep 1;11(9):4650-4656.
[38] Yap LW, Brok J, Pritchard-Jones K. Role of CD56 in Nor- mal Kidney Development and Wilms Tumorigenesis. Fetal Pediatr Pathol. 2017 Feb;36(1):62-75. https://doi.org/10.1 080/15513815.2016.1256358
[39] Wang H, Ma C, Wu J, et al. Clinicopathologic features of the ureteral neuroendocrine tumors. Pathol Res Pract. 2020 Feb;216(2):152788. https://doi.org/10.1016/j. prp.2019.152788[40] Becker JC, Stang A, DeCaprio JA, et al. Merkel cell carcinoma. Nat Rev Dis Primers. 3: 17077. https://doi.org/10.1038/nrdp.2017.77
[41] Sandri A, Donati G, Blanc CD, et al. Anterior chest wall resection and sternal body wedge for primary chest wall tumour: reconstruction technique with biological meshes and titanium plates. J Thorac Dis. 2020 Jan;12(1):17-21. https://doi.org/10.21037/jtd.2019.06.45
[42] Rinke A, Gress TM. Neuroendocrine Cancer, Therapeutic Strategies in G3 Cancers. Digestion. 2017;95(2):109-114. https://doi.org/10.1159/000454761
[43] Lo Russo G, Pusceddu S, Proto C, et al. Treatment of lung large cell neuroendocrine carcinoma. Tumour Biol. 2016 Jun;37(6):7047-57. https://doi.org/10.1007/s13277- 016-5003-4
| Files | ||
| Issue | Vol 8 No 3 (2023): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v8i3.14230 | |
| Keywords | ||
| Chest wall tumors Neuroendocrine tumors Thoracic mass Computed tomography Biopsy ositron emission tomography | ||
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How to Cite
1.
Magro VM, Caturano M, Boccalone E, Scala G, Verrusio W. A Patient with aThoracic Tumefation. CRCP. 2023;8(3):94-100.
