- Case Report
- Open Access
Primary mediastinal leiomyoma: a case report
© licensee BioMed Central Ltd. 2009
- Received: 28 January 2009
- Accepted: 19 June 2009
- Published: 16 July 2009
Leiomyoma of the mediastinum is rare. We report a case of a 57-year-old woman with a cervical mass diving to the intrathoracic. Chest radiography and computed tomography revealed a mass in the right superior mediastinum. The tumor was enucleated by cervicotomy. Histologically, the tumor was diagnosed as leiomyoma.
- Chest Radiography
- Superior Vena
- Smooth Muscle Actin
Leiomyoma of the mediastinum is extremely rare. Only 12 cases of solitary leiomyoma that developed from small vessels in the soft tissue of the mediastinum wall have been reported in the English literature . In the present paper, we will be discussing the case of a 57-year-old woman having a primary mediastinal leiomyoma treated by surgery.
Leiomyomas mediastinal are extremely rare tumors which develop from smooth muscle, usually in the esophagus and large vessels (inferior vena cava, pulmonary artery, and superior vena cava). In our case, there was no tumor dependency to the neighboring structures. Although leiomyoma pathogenesis is obscure, estrogen and traumatic theories were suggested . Primary mediastinal leiomyomas are frequently found at middle-aged women. Symptoms are rare and result mainly from the tumor local mass effect on vital structures. Baldo et al, reported a case of mediastinal leiomyoma presenting a superior vena cava syndrome . Our patient had atypical location of this lesion; this is the second case of the leiomyoma mediastinal with cervical extension to be known. Computed tomography scan usually reveals the size and location of the tumor, however magnetic resonance imaging is more precise for demonstrating the extension of the lesion and its relationship with the adjacent structures . Definitive diagnosis should be achieved by histology, microscopically; leiomyoma consists of monomorphic spindle cells with blunt-ended nuclei, arranged in interlacing fascicles. The specific immune marker, to smooth muscle actin, signs the diagnostic for leiomyoma.
Resection is the adequate treatment of primary mediastinal leiomyoma. If the tumor is vasculared, an embolisation should be performed prior to operating in order to control the bleeding during surgery. The local recurrence is uncommon, but if the mass recurs, the possibility of leiomyosarcoma should be explored .
The primary mediastinal leiomyoma is exceptionally infrequent. It develops from small vessels in the soft tissue of the mediastinum wall. The tumor is surgically removed, and no local recurrence has been reported so far.
Written informed consent was obtained from the patient for publication of this case report, photographic and radiographic images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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