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Ataxia induced by a thymic neuroblastoma in the elderly patient.

Wiesel O, Bhattacharyya S, Vaitkevicius H, Prasad S, McNamee C - World J Surg Oncol (2015)

Bottom Line: Thymic neuroblastoma is a rare tumor with only few reports in modern literature.We report a case of a 62-year-old male who presented with neurological symptoms of ataxia and opsoclonus and an anterior mediastinal mass.This is the first case of thymic neuroblastoma associated with symptomatic central nervous system disease; it is presented with an up-to-date review of the previous cases in the field as well with a review of the literature of post adolescent neuroblastoma.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA. owiesel@partners.org.

ABSTRACT
Thymic neuroblastoma is a rare tumor with only few reports in modern literature. Whereas most data is taken from childhood neuroblastoma, little is known about the characteristics of the disease in the adult and elderly population. There are significant differences between adult and childhood neuroblastoma which are reviewed below. We report a case of a 62-year-old male who presented with neurological symptoms of ataxia and opsoclonus and an anterior mediastinal mass. Ultimately, the patient underwent a resection of the mass and pathologic review identified a thymic neuroblastoma. This is the first case of thymic neuroblastoma associated with symptomatic central nervous system disease; it is presented with an up-to-date review of the previous cases in the field as well with a review of the literature of post adolescent neuroblastoma.

No MeSH data available.


Related in: MedlinePlus

Histology, immunohistochemistry, and gross pathology of the resected specimen. (A) Histology of the mediastinal mass revealed a monotonous population of small- to medium-sized round cells with scant cytoplasm and finely granular chromatin within a background of neutrophils, consistent with the diagnosis of neuroblastoma (H&E, original magnification ×400). (B) Confirmatory immunohistochemistry (IHC) revealed diffuse synaptophysin positivity (original magnification ×400). (C) Pathologic specimen shows 7.5 × 5 × 3.7 cm, tan-white, lobulated, focally hemorrhagic, encapsulated resected anterior mediastinal mass.
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Fig3: Histology, immunohistochemistry, and gross pathology of the resected specimen. (A) Histology of the mediastinal mass revealed a monotonous population of small- to medium-sized round cells with scant cytoplasm and finely granular chromatin within a background of neutrophils, consistent with the diagnosis of neuroblastoma (H&E, original magnification ×400). (B) Confirmatory immunohistochemistry (IHC) revealed diffuse synaptophysin positivity (original magnification ×400). (C) Pathologic specimen shows 7.5 × 5 × 3.7 cm, tan-white, lobulated, focally hemorrhagic, encapsulated resected anterior mediastinal mass.

Mentions: Pathology revealed a 7.5-cm neuroblastoma without capsular invasion. The tumor was adherent to the pericardium but without invasion of neighboring structures including the pericardium. Resection margins were negative for tumor. One removed lymph node was negative for tumor. Immunohistochemistry staining was positive for synaptophysin, chromogranin, and NSE and negative for AE1, AE3, and CD99 (Figure 3). Tumor sequencing revealed no amplification of n-myc oncogene.Figure 3


Ataxia induced by a thymic neuroblastoma in the elderly patient.

Wiesel O, Bhattacharyya S, Vaitkevicius H, Prasad S, McNamee C - World J Surg Oncol (2015)

Histology, immunohistochemistry, and gross pathology of the resected specimen. (A) Histology of the mediastinal mass revealed a monotonous population of small- to medium-sized round cells with scant cytoplasm and finely granular chromatin within a background of neutrophils, consistent with the diagnosis of neuroblastoma (H&E, original magnification ×400). (B) Confirmatory immunohistochemistry (IHC) revealed diffuse synaptophysin positivity (original magnification ×400). (C) Pathologic specimen shows 7.5 × 5 × 3.7 cm, tan-white, lobulated, focally hemorrhagic, encapsulated resected anterior mediastinal mass.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4491252&req=5

Fig3: Histology, immunohistochemistry, and gross pathology of the resected specimen. (A) Histology of the mediastinal mass revealed a monotonous population of small- to medium-sized round cells with scant cytoplasm and finely granular chromatin within a background of neutrophils, consistent with the diagnosis of neuroblastoma (H&E, original magnification ×400). (B) Confirmatory immunohistochemistry (IHC) revealed diffuse synaptophysin positivity (original magnification ×400). (C) Pathologic specimen shows 7.5 × 5 × 3.7 cm, tan-white, lobulated, focally hemorrhagic, encapsulated resected anterior mediastinal mass.
Mentions: Pathology revealed a 7.5-cm neuroblastoma without capsular invasion. The tumor was adherent to the pericardium but without invasion of neighboring structures including the pericardium. Resection margins were negative for tumor. One removed lymph node was negative for tumor. Immunohistochemistry staining was positive for synaptophysin, chromogranin, and NSE and negative for AE1, AE3, and CD99 (Figure 3). Tumor sequencing revealed no amplification of n-myc oncogene.Figure 3

Bottom Line: Thymic neuroblastoma is a rare tumor with only few reports in modern literature.We report a case of a 62-year-old male who presented with neurological symptoms of ataxia and opsoclonus and an anterior mediastinal mass.This is the first case of thymic neuroblastoma associated with symptomatic central nervous system disease; it is presented with an up-to-date review of the previous cases in the field as well with a review of the literature of post adolescent neuroblastoma.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75th Francis Street, Boston, 02115, MA, USA. owiesel@partners.org.

ABSTRACT
Thymic neuroblastoma is a rare tumor with only few reports in modern literature. Whereas most data is taken from childhood neuroblastoma, little is known about the characteristics of the disease in the adult and elderly population. There are significant differences between adult and childhood neuroblastoma which are reviewed below. We report a case of a 62-year-old male who presented with neurological symptoms of ataxia and opsoclonus and an anterior mediastinal mass. Ultimately, the patient underwent a resection of the mass and pathologic review identified a thymic neuroblastoma. This is the first case of thymic neuroblastoma associated with symptomatic central nervous system disease; it is presented with an up-to-date review of the previous cases in the field as well with a review of the literature of post adolescent neuroblastoma.

No MeSH data available.


Related in: MedlinePlus