Giant Mass Research Articles

Case Report: Extensive Temporal Bone Invasion in a Giant Vestibular Schwannoma

BackgroundRare giant vestibular schwannomas (GVSs) invade the temporal bone extensively, which carries unique risks for surgery owing to their complicated relationship with adjacent structures, difficult dissection of the temporal bone, and high risk of complications. The underlying mechanism of this invasive behavior remains unknown.Case descriptionWe report on a 28-year-old woman who presented with typical hearing loss and facial paralysis (House-Brackmann II). Magnetic resonance imaging exhibited a giant mass (∼5.0 cm) in the right cerebellopontine angle (CPA), petrous apex, and middle cranial fossa. Her primary diagnosis was GVS with petrous apex invasion. With the aid of presurgical imaging reconstruction and intraoperative facial nerve monitoring, we adopted a sequential therapeutic strategy, which included microsurgery for the CPA lesion followed by gamma knife radiosurgery (GKRS) for the petrous mass. During follow-up, stable tumor control was achieved with functional preservation of the facial nerve and no other complications. The postoperative immunohistochemical examination demonstrated dramatic intratumoral inflammation, which suggested its potential role in bony erosion. We reviewed the literature of large vestibular schwannoma with a petrous invasion and further discussed its treatment.ConclusionMicrosurgery remains the top therapeutic strategy for GVS. However, gross total resection with functional preservation of cranial nerves is challenging to achieve once the temporal bone is involved. In this case, we applied a planned and sequential approach of microsurgery and GKRS with a promising outcome, which highlighted this combinational strategy in this rare situation. In addition, pathological examination suggested that intratumoral inflammation might play a role in the bony erosion of GVS. Longer observation and more cases are needed to further investigate its molecular mechanism and treatment plan.

Investigation of atrial mass by multi-imaging and biopsy.

The authors describe the case of a child with a history of relapsed acute lymphoblastic leukaemia with a giant intra-auricular lymphomatous mass, submitted to investigation by multiple imaging methods and biopsy.

A case of a giant thoracic schwannoma

Background: Giant solitary schwannomas are rare, benign, and typically slow-growing tumors reaching up to 20 cm in size.Case Description: A 43-year-old male presented with shortness of breath and chest pain. The thoracic MRI showed a giant mass 15 cm in diameter filling the left chest cavity. The lesion was resected utilizing intrathoracic approach and required a multilevel approach. Vertebrectomy with instrumented fusion was performed. The pathological diagnosis was benign schwannoma without nuclear atypia. Postoperatively, the patient fully recovered without sequelae.Conclusion: A 43-year-old male presented with a 15 cm diameter chest mass that proved to be a schwannoma that was resected without long-term sequelae.

Giant lipoma in superior vena cava: A case report and literature review.

IntroductionIntravascular lipomas are rare occurrences, especially in major vessels. This tumour is composed of adipocytes in a fibrous capsule that has a slow growth rate and usually shows no symptoms. There were only eight reports in the literature regarding intravascular lipoma located in the superior vena cava.Case presentationA 54-year-old man had episodes of supraventricular tachycardia and atrial flutter for over a year. Preoperative radiological findings showed a giant mass that arose from the superior vena cava to the right atrium and a biopsy catheter showed that there were no signs of malignancy. The patient then underwent surgery through median sternotomy and the mass was extirpated on the highest part of the stalk that could be reached. The patient was stable and remained to show no symptoms or evidence of residual mass or stalk in 2 years follow-up.ConclusionThe surgical approach in excising lipoma in SVC should be considered wisely with the support of adequate preoperative diagnosis. Since lipoma is a very slow-growing tumour, extensive manipulation that could increase surgical technique difficulty or postoperative morbidity and mortality is not necessary.

Giant retroperitoneal well-differentiated liposarcoma presenting in emergency with intestinal occlusion: Case report and review of the literature.

Introduction and importanceLiposarcoma (LPS) represents the most common type of retroperitoneal sarcoma (RPS) and can be classified into four subtypes. Preoperative diagnosis of retroperitoneal liposarcoma (RLPS) is a challenge because of its late and nonspecific clinical presentation. Imaging may be helpful for determining the correct diagnosis. Surgery represents a potentially curative treatment of RLPS.Case presentationA 55-year-old Caucasian female presented to the Emergency Department with a two-day history of abdominal pain, abdominal distension, inability to pass gas or stool, nausea, vomiting and lipothymia. Abdominal examination revealed abdominal distention, abdominal pain without obvious muscle guarding and a giant non-tender mass. Laboratory tests reported neutrophilic leukocytosis and anemia. Abdominal contrast-enhanced computed tomography (CECT) showed a heterogeneous and hypodense giant retroperitoneal mass compressing and displacing the surrounding organs and vessels. The patient underwent excision of a giant retroperitoneal mass. The postoperative course of the patient was uneventful.Clinical discussionRLPS is a malignant neoplasm that can slowly grow to enormous size with possible involvement of adjacent organs and vessels; it may recur locally and has a minimal capacity to metastasize. Preoperative diagnosis and staging of RLPS are important to establish appropriate management and prognosis. Surgery represents the gold standard for non-metastatic RLPS treatment.ConclusionRLPS is a rare malignant neoplasm generally difficult to detect early due to its late and nonspecific clinical presentation. CECT represents the most commonly used modality for diagnosis, staging and preoperative evaluation. Surgery represents the appropriate treatment of non-metastatic RLPS.

GIANT THORACIC MASS - THE STORY OF A SOLITARY FIBROUS TUMOUR.

The tumours of the pleura are a vast and diverse field. One of the lesser known and less common tumour is the solitary fibrous tumour of the pleura, representing about 5% of these types of tumours. The authors present the case of a woman admitted to the emergency department with symptoms of dizziness and vomits. Imaging studies showed a giant thoracic mass on the left hemithorax, with a biopsy indicating a solitary fibrous tumour. The patient was referred for surgery, which was performed via thoracotomy. In the postoperative period she developed an acute pulmonary oedema secondary to lung reexpansion and fluid overload, with a good response to fluid restriction and intravenous diuretics.

ОСОБЕННОСТИ ДИАГНОСТИКИ И ЛЕЧЕНИЯ ГИГАНТСКОЙ АНГИОМИОЛИПОМЫ ПОЧКИ (КЛИНИЧЕСКИЙ СЛУЧАЙ)

Introduction. One of the rare complex diseases in clinical practice is Bourneville-Pringle disease (tuberous sclerosis). It is a genetically determined polysystemic disease with an autosomal dominant type of inheritance, one of the manifestations of which are renal angiomyolipomas. Angiomyolipoma is a benign kidney tumor. It consists of epithelioid, smooth muscle cells and adipose tissue and has abundant abnormal vascularization. Aim. We analyze a complex clinical case in a patient with a giant angiomyolipoma of a single kidney. Material and methods. Patient S., 58 years old, was urgently admitted to the urology department. The patient complained of pain in the left lumbar region, in the left half of the abdomen, blood impurities in the urine. General clinical, laboratory and instrumental research tools were conducted. Results and discussion. According to the spiral CT of the kidneys with contrasting, in the left kidney a giant mass with a violation of its architectonics, with signs of hemorrhage and a formed hematoma in the upper third of the mass and hemorrhagic impregnation of its lower half was found. Surgical treatment was prescribed, during which embolization of the segmental arteries of the left kidney, selective angiography of the left renal artery, total nephrectomy on the left with a successful outcome were performed. Conclusion. On the basis of the given clinical case, it should be concluded that despite the benign nature of the renal angiomyolipoma, the tumor has reached gigantic sizes due to the late treatment of the patient caused by concomitant oligophrenia. In this regard, the late diagnosis has led to life-threatening complications that required immediate decision-making. The given clinical observation shows the success of the chosen surgical tactics in the form of a radical operation that allowed saving the life of the patient with a rare disease. The patient was discharged from the hospital for outpatient follow-up by an urologist and a nephrologist. Regular hemodialysis, monitoring with the help of laboratory and instrumental research tools are prescribed. The patient was put on the waiting list for renal trans- plantation in specialized centers in Russia.

Giant paleo-seafloor craters and mass wasting associated with magma-induced uplift of the upper crust

Giant seafloor craters are known along many a continental margin with recurrent mass-wasting deposits. However, the impact of breakup-related magmatism on the evolution of such craters is barely understood. Using high-quality geophysical datasets, this work examines the genetic relationship among the location of magmatic sills, forced folds and the formation of giant paleo-seafloor craters underneath an ancient mass-transport complex in the Møre and Vøring basins, offshore Norway. The data reveal that forced folding of near-seafloor strata occurred because of the intrusion of several interconnected magmatic sills. Estimates of 1-dimensional uplift based on well data show that uplift occurred due to the intrusion of magma in Upper Cretaceous to Lower Eocene strata. Our findings also prove that subsurface fluid plumbing associated with the magmatic sills was prolonged in time and led to the development of several vertical fluid flow conduits, some of which triggered mass wasting in Neogene to Recent times. The repeated vertical expulsion of subsurface fluids weakened the strata on the continental slope, thereby promoting mass wasting, the selective cannibalization of the paleo-seafloor, and the formation of elongated craters at the basal shear zone of the mass-transport complex. Significantly, the model presented here proves a close link between subsurface magmatic plumbing systems and mass wasting on continental margins.

Carpal Tunnel Syndrome Secondary to the Lipoma Mass: A Case Report and Review of Literature

Background: Lipomas are benign adipocyte proliferations and the most common tumors in soft tissue, although the appearance of this tumor in the hand is rare. The most common peripheral compressive neuropathy is carpal tunnel syndrome (CTS). CTS caused by a space-occupying lesion such as lipomas is rare and causes more complications than idiopathic CTS. Case Report: This report was about a case of a 62-year-old woman with a giant painless mass on the first web of her right hand, with no systemic symptom and just a burning sensation in her fingers. After evaluations, CTS was diagnosed. Surgical dissection of the mass was performed, and the patient’s symptoms improved. The pathology report indicated that the mass was a lipoma. Conclusion: It is essential to examine the presence of different masses when the patient has neurological symptoms without justifying the history.

Clinical Images: Giant mass on the forehead in Kimura disease.

The patient, a 68-year-old Asian man with a history of nephrotic syndrome, presented to our department with multiple subcutaneous masses that developed over the past 50 years. The masses were painless, soft, and predominantly located in the head. The mass on the forehead was dome-shaped and had a diameter of 7 cm and a height of 3 cm (A). Blood tests showed eosinophilia and elevated immunoglobulin E (IgE) levels. Serum immunoglobulin G4 levels were normal. Ultrasonography showed heterogeneous masses with marked associated internal hyperemia (B). Magnetic resonance imaging showed T1-weighted isointense and T2-weighted hyperintense masses. A needle biopsy of the forehead mass showed stromal fibrosis, multiple lymphoid follicles, and infiltration of inflammatory cells, mainly eosinophils and lymphocytes. The patient was diagnosed with Kimura disease (KD). The masses shrank rapidly after administration of 30 mg/day of prednisolone for 2 weeks. KD is a rare chronic inflammatory disorder mainly affecting young Asian men. It presents as subcutaneous masses, typically in the head and neck, and is associated with eosinophilia and elevated IgE levels (1). It often affects the cervical lymph nodes and salivary glands (1). It is often associated with renal involvement, such as nephrotic syndrome (2). Glucocorticoids, surgical excision, and radiation therapy are the treatments of choice (3). The diagnosis of KD can be difficult because of its rarity. KD should be considered as a differential diagnosis when patients present with painless subcutaneous masses in the head and neck region with eosinophilia and elevated serum IgE levels.

Radiocarbon Dating of the Nyixoi Chongco Rock Avalanche, Southern Tibet: Search for Signals of Seismic Shaking and Hydroclimatic Events

Landslides are important agents of the surface processes involved in the growth of mountainous topography. Dating prehistoric landslides is a prerequisite for establishing the relationships between prehistoric slope instability, and past climatic regimes and paleoseismic records. The Nyixoi Chongco rock avalanche (NCRA) is located in the Angang graben within the N–S trending rift zone in southern Tibet. It represents a giant prehistoric mass wasting event that was characterized by exceptional mobility and a large volume. However, the exact emplacement time and origin of the NCRA are still controversial. In this study, we conducted 14C dating of peat layers and snail shells to constrain the emplacement age of the NCRA. The 14C ages of the organic material and plant remnants in the basal peat layer are 1272–1389 and 1299–1404 cal AD, respectively. The 14C ages of aquatic snail shells and the bog overlying the rock avalanche are 425–565 and 1022–159 cal AD, respectively. These results indicate that the NCRA consisted of at least two separate and distinct events, instead of the single event suggested by previous studies. Based on field investigations and temporal correlations, we infer that there may be no paleoseismic records in the Angang graben that would corroborate a coseismic trigger for the NCRA. Therefore, we suggest that the 14C ages of the sediments below and above the landslide rocks should be interpreted carefully. The 14C ages alone do not provide sufficient evidence to infer the true trigger of the NCRA event.

Primary Pulmonary Fibrosarcoma in Giant Mass Appearance: A Rare Case Report

Primary Pulmonary Fibrosarcoma in Giant Mass Appearance: A Rare Case Report

Malignant Transformation of an Aneurysmal Bone Cyst to Huge Fibroblastic Osteosarcoma without Radiation Exposure: Proper Surgical Management is More than a Challenge

In this study, we present a case of aneurysmal bone cyst presenting as pathologic fracture of the left proximal femur. The patient, who had history of multiple surgeries, was referred to us with a giant mass. The patient was found to develop osteosarcoma without radiation exposure. External hemipelvectomy was performed.Appropriate surgical management of a huge tumor that repeatedly operated is more than a challenge like this case. Aneurysmal bone cysts rarely present as pathologic fractures initially. In addition, to the best of our knowledge, the number of aneurysmal bone cysts (ABCs) exhibiting malignant transformation to osteosarcoma without radiation exposure is less than ten in the literature.Keywords: aneurysmal bone cyst, osteosarcoma, malignant transformation, hemipelvectomy

Giant Orbital Rhabdomyosarcoma in a Newborn: Case Report

Rhabdomyosarcoma is the single most common type of soft tissue sarcoma in childhood and teenage, it has been reported from birth to the seventh decade, with the majority of cases presenting in early childhood but it is very rare in neonates. The orbit including the eyelids is the usual primary site in the head and neck, and it is a highly malignant tumor. There have been only a few cases of congenital orbital rhabdomyosarcoma previously reported in the literature. We report a case of a newborn girl that was admitted in our structure 2 days after her birth with giant right orbital mass inducing proptosis that was discovered at birth. MRI showed a poorly defined mass but biopsy of the tumor confirmed the diagnosis of Rhabdomyosarcoma. Chemotherapy was started accordingly with VAC regimen with a good evolution under treatment infortunatly the patient died at four month old from an infectious disease because she doen’t receive any vaccination. Congenital RMS has a poor prognosis and must benefit from a multidisciplinary approach. Children with cancer need to be immunized against the common vaccine-preventable diseases sometimes during ongoing chemotherapy to increase their chance of survival. Prenatal diagnosis may also improve the prognosis of these patients.

Giant hydronephrosis presented as a huge abdominal mass in a 16-year-old female: a case report

Giant hydronephrosis owing to ureteropelvic junction obstruction is a rare condition characterized by the accumulation of more than 1000 ml of urine in the pyelocaliceal system. It could mimic the other benign cystic kidney disease or other causes of abdominal mass in radiologic images. We reported a 16-year-old female who presented with three months of abdominal pain and gradual abdominal mass ingrowth. Abdominal computed tomography scan showed a giant left cystic mass favored hydronephrosis secondary to ureteropelvic junction obstruction. The patient underwent a left nephrectomy, and more than 12 litters of turbid urine were suctioned from the affected kidney. In conclusion, giant hydronephrosis is an infrequent entity and should be considered in the differential diagnosis of large cystic abdominal masses. The treatment is determined by the underlying cause and the visual appeal of the affected kidney.

Transoral Excision of Sublingual and Submental Dermoid Cyst of the Floor of the Mouth: A Case Report

Background: A dermoid cyst is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. It usually presents as a non-tender, slow-growing swelling in the sublingual region. Case presentation: A large lesion was found in the sublingual and submandibular regions of a 15-yearold female patient who presented to our clinic with the chief complaint of a sublingual mass that had been present for many years but had enlarged over the last year. Computed tomography (CT) scans revealed a giant cystic mass that was a 4.6 x 3.3 cm flask-shaped cystic lesion with a non-enhancing wall in the midline of the sublingual space. Magnetic resonance imaging (MRI) with contrast revealed a well-defined cystic mass with heterogeneous fluid on all sequences. The histopathology report was suggestive of a dermoid cyst. The intraoral approach was preferred for surgery, and no recurrence or complaints were detected during the follow-up period. Conclusion: The pathological diagnosis of the presented case was an epidermoid cyst. For giant dermoid cysts, a surgical incision is considered an effective treatment of choice. This offers a good prognosis and very low chances of recurrence. To achieve the best cosmetic effects, an intraoral technique should be chosen whenever possible.

Giant Ovarian Mass: About an Uncommon Case Report

Giant Ovarian Mass: About an Uncommon Case Report

Intrathoracic Giant Mass with Anomalous Vascular Origin in an Asymptomatic Patient: A Case Report

Diagnostic and surgical difficulties were presented in case of a giant mass, found incidentally, in a 65-year-old healthy and asymptomatic man. The patient underwent different diagnostic procedures. Surgery was the treatment of choice. A combination of both open technique and videothoracoscopy to reduce the risk of seeding, pending a certain diagnosis, was resolutive. The postoperative period and recovery time were uneventful. The patient was discharged on the 5th postoperative day. The histological diagnosis was benign schwannoma. There are different aspects to think about, based also on the experience of each center. According to our experience, this is a rare situation; the combined surgical techniques to control the vascular risk and tissue infiltration of the mass seemed to us the approach of choice.

574 Giant left atrial myxoma in ischaemic stroke

Abstract Aims Primary cardiac tumours are rare; most are benign, and of these, around half are myxomas, often located in the left atrium. Clinical presentation is variable. Ischaemic stroke is a rare, although real and potentially fatal, complications of cardiac myxomas. Methods and results We present a case of a 51-year-old man, ex- smoker, obese, with a history of hypertension and COPD, presented to our emergency department with right-sided hemiplegia and aphasia caused by ischaemic stroke. Brain computed tomography revealed cerebral perfusion deficit. The patient was underwent intravenous thrombolytic strategy and intubated transferred in Reanimation. TTE showed a large left atrial mass attached to the interatrial septum, with a friable appearance, suggestive of myxoma. The 2D and 3D TEE detected a giant space-occupying mass (60 × 20 mm diameter) in the left atrium, coral-like, and with a friable appearance, the most apical portion prolapsed into the left ventricle during diastole, causing fixed obstruction to flow in the left ventricular inflow tract. Computed tomography angiography (CTA) confirmed the giant mass in the left atrium. In view of the risk of imminent embolization, the emergent surgical excision of the tumour was performed. The tumour and its neck, including part of the atrial septum, were fully resected and the atrial septum was directly closed. Subsequent histopathological findings confirmed the diagnosis of atrial myxoma. Post-operative echocardiography showed no residual tumour. Symptomatic cardiac myxoma may present with one of the three classic clinical presentations of the Goodwin’s triad, which include intracardiac obstruction, constitutional symptoms, and embolism. The obstructive pattern mimics mitral or tricuspid valve disease and results from atrioventricular valve obstruction. Constitutional or systemic manifestations include fatigue, fever, weight loss, arthralgia, myalgia, erythematous rash, and laboratory findings such as anaemia and elevated ESR, CRP, and globulins. Systemic embolization from myxoma occurs in around a third of cases. Of these, the most serious is cerebrovascular embolism, which may result in cerebral stroke. In addition, embolization of coronary arteries, kidneys, intestines, and extremities can also occur. The tumour size, location, and macroscopic appearance, along with mean platelet volume and platelet count, are closely associated with embolic events. Echocardiography remains the method of choice for diagnosis and morphological characterization of myxoma. Two patterns have been established by echocardiography: round, with a solid appearance and a firm surface, and polypoid, with an irregular outline and a friable surface. The incidence of systemic embolization is higher in those with an irregular and friable surface, as well as in polypoid tumours and those that prolapse into the ventricle. Once a diagnosis of myxoma is established, surgical resection is the only effective treatment and should be performed immediately, in view of the risk of embolic complications. Conclusions With this case report, we stress the fundamental importance of echocardiography in new onset of neurological deficit to prevent potentially fatal outcomes.

Giant pedunculated mass arising from the left tonsillar fossa.

Journal of Paediatrics and Child HealthVolume 57, Issue 12 p. 2034-2034 Images of the Month Giant pedunculated mass arising from the left tonsillar fossa Dr Daniela Codrich, Dr Daniela Codrich Department of Paediatric Surgery and Urology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Paola Staffa, Dr Paola Staffa Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Alessandro Boscarelli, Dr Alessandro Boscarelli orcid.org/0000-0003-1934-1764 Department of Paediatric Surgery and Urology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Domenico L Grasso, Dr Domenico L Grasso Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Enrico Muzzi, Dr Enrico Muzzi Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Eva Orzan, Dr Eva Orzan Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Jurgen Schleef, Dr Jurgen Schleef Department of Paediatric Surgery and Urology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this author Dr Daniela Codrich, Dr Daniela Codrich Department of Paediatric Surgery and Urology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Paola Staffa, Dr Paola Staffa Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Alessandro Boscarelli, Dr Alessandro Boscarelli orcid.org/0000-0003-1934-1764 Department of Paediatric Surgery and Urology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Domenico L Grasso, Dr Domenico L Grasso Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Enrico Muzzi, Dr Enrico Muzzi Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Eva Orzan, Dr Eva Orzan Unit of Paediatric Audiology and Otorhinolaryngology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this authorDr Jurgen Schleef, Dr Jurgen Schleef Department of Paediatric Surgery and Urology, Institute of Maternal and Child Health – IRCCS Burlo Garofolo, Trieste, ItalySearch for more papers by this author First published: 13 December 2021 https://doi.org/10.1111/jpc.1_15416Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume57, Issue12December 2021Pages 2034-2034 RelatedInformation