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Vol.52 No.7 contents | Japanese/English |
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- Case Report -
A Case of Primary Alveolar Soft Part Sarcoma of the Chest Wall
Shunsuke Ito1, Yoshihiro Hirai1, Katsuya Watanabe2, Akiko Tonooka3, Toshimasa Uekusa3, Takeshi Kaneko41Department of Respiratory Medicine, 2Department of Respiratory Surgery, 3Department of Pathology, Japan Labour Health and Welfare Organization, Kanto Rosai Hospital, Japan, 4Respiratory Center, Yokohama City University Medical Center, Japan
Background. Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor accounting for less than 1% of all soft tissue tumors that develop mainly in the trunk and limbs, particularly in the lower limbs, of children and young adults. We report a rare case of ASPS showing intrathoracic growth which was initially detected on chest X-ray film as a lung tumor during a health checkup. Case. A 19-year-old man was referred to our department for detailed examinations in April 2011 after a nodular shadow was detected on a chest radiograph taken at a health checkup. An almost round nodular shadow (diameter, 20 mm) with a smooth surface was identified in the right upper lung field on a plain chest radiograph, and contrast-enhanced chest computed tomography (CT) showed a mass (diameter, 24 mm) in contrast with a large area of the dorsal pleura adjacent to the right upper lobe and protruding into the thoracic cavity. Because the patient was young, it was important to exclude malignancy and therefore thoracoscopic surgery was performed for early diagnosis and resection. The tumor was thoracoscopically resected in July 2011. Resected tumor cells were immunoreactive for transcription factor E3, leading to a diagnosis of ASPS. Whole-body positron emission tomography-CT scan and magnetic resonance imaging of the brain and lower extremities, performed after making the definitive diagnosis, detected no metastatic lesions, indicating that the chest wall was the primary site of ASPS. Conclusion. As pleural tumors are considered to be benign disease, we tend to take a wait and see approach. However, we should consider the possibility of malignant disease and the importance of proactively performing histopathological examination of tumor specimens obtained by CT-guided lung biopsy or thoracoscopic resection for early definitive diagnosis.
key words: Chest wall, Primary, Alveolar soft part sarcoma
Received: September 4, 2012
Accepted: November 30, 2012
JJLC 52 (7): 1052-1056, 2012
