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Mesenchymal Tumors of the Mediastinum

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Diagnostic Thoracic Pathology
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Abstract

Tumors of mesenchymal origin are relatively rare neoplasms that are most frequently found in the soft tissues of the extremities or in the abdomen. Primary sarcomas arising in the mediastinum are unusual entities, representing less than 10% of all adult mediastinal tumors and less than 2% of all soft tissue sarcomas. Approximately half of the primary mediastinal tumors of mesenchymal origin are estimated to be malignant. Mediastinal sarcomas may arise de novo or, rarely, in the context of somatic transformation of a mediastinal germ cell tumor (most commonly rhabdomyosarcomas and angiosarcomas). Overall, most soft tissue tumors reported in other anatomic sites have also been recognized in the mediastinum, resulting in a heterogeneous group of neoplasms. Among these, neurogenic tumors are by far the most common, accounting for approximately 20% of all adult and 35% of all pediatric mediastinal tumors. Liposarcomas, solitary fibrous tumors, and synovial sarcomas are other common mesenchymal lesions in this particular location. Due to the rarity and heterogeneity of mediastinal sarcomas, as well as the complex anatomy in this site, no consistent therapy approach has been outlined and the outlook for these patients remains poor. Surgical management remains the preferential treatment and completeness of surgical resection is an important factor determining survival in these patients.

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References

  1. Macchiarini P, Ostertag H. Uncommon primary mediastinal tumours. Lancet Oncol. 2004;5:107–18.

    Article  PubMed  Google Scholar 

  2. Silverman NA, Sabiston DC Jr. Mediastinal masses. Surg Clin North Am. 1980;60:757–77.

    Article  CAS  PubMed  Google Scholar 

  3. Burt M, Ihde JK, Hajdu SI, et al. Primary sarcomas of the mediastinum: results of therapy. J Thorac Cardiovasc Surg. 1998;115:671–80.

    Article  CAS  PubMed  Google Scholar 

  4. Paquette M, Truong PT, Hart J, et al. Primary sarcoma of the mediastinum: a report of 16 cases referred to the British Columbia Cancer Agency. J Thorac Oncol. 2010;5:898–906.

    Article  PubMed  Google Scholar 

  5. Malagón HD, Valdez AM, Moran CA, et al. Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol. 2007;31:1356–62.

    Article  PubMed  Google Scholar 

  6. Wychulis AR, Payne WS, Clagett OT, et al. Surgical treatment of mediastinal tumors: a 40 year experience. J Thorac Cardiovasc Surg. 1971;62:379–92.

    Article  CAS  PubMed  Google Scholar 

  7. Davis RD Jr, Oldham HN Jr, Sabiston DC Jr. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg. 1987;44:229–37.

    Article  PubMed  Google Scholar 

  8. Benjamin SP, McCormack LJ, Effler DB, et al. Primary tumors of the mediastinum. Chest. 1972;62:297–303.

    Article  CAS  PubMed  Google Scholar 

  9. Azarow KS, Pearl RH, Zurcher R, et al. Primary mediastinal masses. A comparison of adult and pediatric populations. J Thorac Cardiovasc Surg. 1993;106:67–72.

    Article  CAS  PubMed  Google Scholar 

  10. den Bakker MA, Marx A, Mukai K, et al. Mesenchymal tumours of the mediastinum–part II. Virchows Arch. 2015;467:501–17.

    Article  CAS  Google Scholar 

  11. Rieker RJ, Marx A, Agaimy A, et al. Mesenchymal tumors of the mediastinum. Pathologe. 2016;37:449–56.

    Article  CAS  PubMed  Google Scholar 

  12. Strollo DC, Rosado de Christenson ML, Jett JR. Primary mediastinal tumors. Part 1: tumors of the anterior mediastinum. Chest. 1997;112:511–22.

    Article  CAS  PubMed  Google Scholar 

  13. Strollo DC, Rosado-de-Christenson ML, Jett JR. Primary mediastinal tumors: part II. Tumors of the middle and posterior mediastinum. Chest. 1997;112:1344–57.

    Article  CAS  PubMed  Google Scholar 

  14. Hahn HP, Fletcher CD. Primary mediastinal liposarcoma: clinicopathologic analysis of 24 cases. Am J Surg Pathol. 2007;31:1868–74.

    Article  PubMed  Google Scholar 

  15. Coindre JM, Terrier P, Bui NB, et al. Prognostic factors in adult patients with locally controlled soft tissue sarcoma. A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group. J Clin Oncol. 1996;14:869–77.

    Article  CAS  PubMed  Google Scholar 

  16. Tam CG, Broome DR, Shannon RL. Desmoid tumor of the anterior mediastinum: CT and radiologic features. J Comput Assist Tomogr. 1994;18:499–501.

    Article  CAS  PubMed  Google Scholar 

  17. Xu H, Koo HJ, Lim S, et al. Desmoid-type fibromatosis of the thorax: CT, MRI, and FDG PET. Characteristics in a large series from a tertiary referral center. Medicine (Baltimore). 2015;94:e1547.

    Article  Google Scholar 

  18. Fletcher CDM, Bridges JA, Hogendoorn PCW, et al. WHO classification of tumours of soft tissue and bone. Lyon: IARC Press; 2013.

    Google Scholar 

  19. Bouchikh M, Arame A, Riquet M, et al. Cardiac failure due to a giant desmoid tumour of the posterior mediastinum. Eur J Cardiothorac Surg. 2013;44:1137–9.

    Article  PubMed  Google Scholar 

  20. Lee JH, Jeong JS, Kim SR, et al. Mediastinal desmoid tumor with remarkably rapid growth: a case report. Medicine (Baltimore). 2015;94:e2370.

    Article  Google Scholar 

  21. Clark SK, Phillips RK. Desmoids in familial adenomatous polyposis. Br J Surg. 1996;83:1494–504.

    Article  CAS  PubMed  Google Scholar 

  22. Wallis YL, Morton DG, McKeown CM, et al. Molecular analysis of the APC gene in 205 families: extended genotype-phenotype correlations in FAP and evidence for the role of APC amino acid changes in colorectal cancer predisposition. J Med Genet. 1999;36:14–20.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. den Bakker MA, Marx A, Mukai K, et al. Mesenchymal tumours of the mediastinum–part I. Virchows Arch. 2015;467:487–500.

    Article  CAS  Google Scholar 

  24. Inase N, Ichioka M, Akamatsu H, et al. Mediastinal fibromatosis presenting with superior vena cava syndrome. Respiration. 1999;66:464–6.

    Article  CAS  PubMed  Google Scholar 

  25. Neinstein LS. Life-threatening desmoid tumor. J Adolesc Health Care. 1990;11:453–5.

    Article  CAS  PubMed  Google Scholar 

  26. Winer-Muram HT, Bowman LC, Parham D. Intrathoracic desmoid tumor: CT and MRI appearance. South Med J. 1994;87:1007–9.

    Article  CAS  PubMed  Google Scholar 

  27. Plukker JT, van Oort I, Vermey A, et al. Aggressive fibromatosis (non-familial desmoid tumour): therapeutic problems and the role of adjuvant radiotherapy. Br J Surg. 1995;82:510–4.

    Article  CAS  PubMed  Google Scholar 

  28. Dosios TJ, Angouras DC, Floros DG. Primary desmoid tumor of the posterior mediastinum. Ann Thorac Surg. 1998;66:2098–9.

    Article  CAS  PubMed  Google Scholar 

  29. Nakagiri T, Koseki M, Nakamoto K, et al. Paraesophageal mediastinal desmoid tumor: case report. Gen Thorac Cardiovasc Surg. 2007;55:125–9.

    Article  PubMed  Google Scholar 

  30. Papagelopoulos PJ, Mavrogenis AF, Mitsiokapa EA, et al. Current trends in the management of extra-abdominal desmoid tumours. World J Surg Oncol. 2006;4:21.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Bhattacharya B, Dilworth HP, Iacobuzio-Donahue C, et al. Nuclear beta-catenin expression distinguishes deep fibromatosis from other benign and malignant fibroblastic and myofibroblastic lesions. Am J Surg Pathol. 2005;29:653–9.

    Article  PubMed  Google Scholar 

  32. Montgomery E, Torbenson MS, Kaushal M, Fisher C, Abraham SC. Beta-catenin immunohistochemistry separates mesenteric fibromatosis from gastrointestinal stromal tumor and sclerosing mesenteritis. Am J Surg Pathol. 2002;26:1296–301.

    Article  PubMed  Google Scholar 

  33. Abraham SC, Reynolds C, Lee JH, et al. Fibromatosis of the breast and mutations involving the APC/beta-catenin pathway. Hum Pathol. 2002;33:39–46.

    Article  CAS  PubMed  Google Scholar 

  34. Amary MF, Pauwels P, Meulemans E, et al. Detection of beta-catenin mutations in paraffin-embedded sporadic desmoid-type fibromatosis by mutation-specific restriction enzyme digestion (MSRED): an ancillary diagnostic tool. Am J Surg Pathol. 2007;31:1299–309.

    Article  PubMed  Google Scholar 

  35. van de Rijn M, Lombard CM, Rouse RV. Expression of CD34 by solitary fibrous tumors of the pleura, mediastinum, and lung. Am J Surg Pathol. 1994;18:814–20.

    Article  PubMed  Google Scholar 

  36. Musyoki FN, Nahal A, Powell TI. Solitary fibrous tumor: an update on the spectrum of extrapleural manifestations. Skelet Radiol. 2012;41:5–13.

    Article  Google Scholar 

  37. Suehisa H, Yamashita M, Komori E, et al. Solitary fibrous tumor of the mediastinum. Gen Thorac Cardiovasc Surg. 2010;58:205–8.

    Article  PubMed  Google Scholar 

  38. Zhang L, Liu X, Li X, et al. Diagnosis and surgical treatment of mediastinal solitary fibrous tumor. Asia Pac J Clin Oncol. 2017;13:e473–80.

    Article  PubMed  Google Scholar 

  39. Witkin GB, Rosai J. Solitary fibrous tumor of the mediastinum. A report of 14 cases. Am J Surg Pathol. 1989;13:547–57.

    Article  CAS  PubMed  Google Scholar 

  40. Li Z, Wang J, Zhu Q, et al. Huge solitary fibrous tumor of the pleura with hypoglycemia and hypokalemia: a case report. Ann Thorac Cardiovasc Surg. 2014;20:165–8.

    Article  PubMed  Google Scholar 

  41. Aydemir B, Celik S, Okay T, et al. Intrathoracic giant solitary fibrous tumor. Am J Case Rep. 2013;14:91–3.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Chu X, Zhang L, Xue Z, et al. Solitary fibrous tumor of the pleura: an analysis of forty patients. J Thorac Dis. 2012;4:146–54.

    PubMed  PubMed Central  Google Scholar 

  43. Xiang Y, Tu S, Zhang F. Rapid metastasis of mediastinal solitary fibrous tumor: report a case. Medicine (Baltimore). 2017;96:e9307.

    Article  Google Scholar 

  44. Cardillo G, Carbone L, Carleo F, et al. Solitary fibrous tumors of the pleura: an analysis of 110 patients treated in a single institution. Ann Thorac Surg. 2009;88:1632–7.

    Article  PubMed  Google Scholar 

  45. Milano MT, Singh DP, Zhang H. Thoracic malignant solitary fibrous tumors: a population-based study of survival. J Thorac Dis. 2011;3:99–104.

    PubMed  PubMed Central  Google Scholar 

  46. England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol. 1989;13:640–58.

    Article  CAS  PubMed  Google Scholar 

  47. de Perrot M, Fischer S, Bründler MA, et al. Solitary fibrous tumors of the pleura. Ann Thorac Surg. 2002;74:285–93.

    Article  PubMed  Google Scholar 

  48. Chmielecki J, Crago AM, Rosenberg M, et al. Whole-exome sequencing identifies a recurrent NAB2-STAT6 fusion in solitary fibrous tumors. Nat Genet. 2013;45:131–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Mohajeri A, Tayebwa J, Collin A, et al. Comprehensive genetic analysis identifies a pathognomonic NAB2/STAT6 fusion gene, nonrandom secondary genomic imbalances, and a characteristic gene expression profile in solitary fibrous tumor. Genes Chromosomes Cancer. 2013;52:873–86.

    Article  CAS  PubMed  Google Scholar 

  50. Robinson DR, Wu YM, Kalyana-Sundaram S, et al. Identification of recurrent NAB2-STAT6 gene fusions in solitary fibrous tumor by integrative sequencing. Nat Genet. 2013;45:180–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Doyle LA, Vivero M, Fletcher CD, et al. Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics. Mod Pathol. 2014;27:390–5.

    Article  CAS  PubMed  Google Scholar 

  52. Yoshida A, Tsuta K, Ohno M, et al. STAT6 immunohistochemistry is helpful in the diagnosis of solitary fibrous tumors. Am J Surg Pathol. 2014;38:552–9.

    Article  PubMed  Google Scholar 

  53. Kovach SJ, Fischer AC, Katzman PJ, et al. Inflammatory myofibroblastic tumors. J Surg Oncol. 2006;94:385–91.

    Article  PubMed  Google Scholar 

  54. Gleason BC, Hornick JL. Inflammatory myofibroblastic tumours: where are we now? J Clin Pathol. 2008;61:428–37.

    Article  CAS  PubMed  Google Scholar 

  55. Coffin CM, Watterson J, Priest JR, et al. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol. 1995;19:859–72.

    Article  CAS  PubMed  Google Scholar 

  56. Gorolay V, Jones B. Inflammatory myofibroblastic tumor of mediastinum with esophageal and bronchial invasion: a case report and literature review. Clin Imaging. 2017;43:32–5.

    Article  PubMed  Google Scholar 

  57. Chen CH, Lin RL, Liu HC, et al. Inflammatory myofibroblastic tumor mimicking anterior mediastinal malignancy. Ann Thorac Surg. 2008;86:1362–4.

    Article  PubMed  Google Scholar 

  58. Crespo C, Navarro M, González I, et al. Intracranial and mediastinal inflammatory myofibroblastic tumour. Pediatr Radiol. 2001;31:600–2.

    Article  CAS  PubMed  Google Scholar 

  59. Guan Y, Chen G, Zhang W, et al. Computed tomography appearance of inflammatory myofibroblastic tumor in the mediastinum. J Comput Assist Tomogr. 2012;36:654–8.

    Article  PubMed  Google Scholar 

  60. Makimoto Y, Nabeshima K, Iwasaki H, et al. Inflammatory myofibroblastic tumor of the posterior mediastinum: an older adult case with anaplastic lymphoma kinase abnormalities determined using immunohistochemistry and fluorescence in situ hybridization. Virchows Arch. 2005;446:451–5.

    Article  PubMed  Google Scholar 

  61. Meng X, Wang R. Inflammatory myofibroblastic tumor occurs in the mediastinum. J Cancer Res Ther. 2013;9:721–3.

    Article  PubMed  Google Scholar 

  62. Ramachandra S, Hollowood K, Bisceglia M, et al. Inflammatory pseudotumour of soft tissues: a clinicopathological and immunohistochemical analysis of 18 cases. Histopathology. 1995;27:313–23.

    Article  CAS  PubMed  Google Scholar 

  63. Sugiyama K, Nakajima Y. Inflammatory myofibroblastic tumor in the mediastinum mimicking a malignant tumor. Diagn Interv Radiol. 2008;14:197–9.

    PubMed  Google Scholar 

  64. Yamaguchi M, Yoshino I, Osoegawa A, et al. Inflammatory myofibroblastic tumor of the mediastinum presenting as superior vena cava syndrome. J Thorac Cardiovasc Surg. 2003;126:870–2.

    Article  PubMed  Google Scholar 

  65. Coffin CM, Hornick JL, Fletcher CD. Inflammatory myofibroblastic tumor: comparison of clinicopathologic, histologic, and immunohistochemical features including ALK expression in atypical and aggressive cases. Am J Surg Pathol. 2007;31:509–20.

    Article  PubMed  Google Scholar 

  66. Meyerding HW, Broders AC, Hargrave RL. Clinical aspects of fibrosarcoma of the soft tissues of the extremities. Surg Gynecol Obstet. 1936;62:1010–9.

    Google Scholar 

  67. Toro JR, Travis LB, Wu HJ, et al. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978-2001: an analysis of 26,758 cases. Int J Cancer. 2006;119:2922–30.

    Article  CAS  PubMed  Google Scholar 

  68. Bahrami A, Folpe AL. Adult-type fibrosarcoma: a reevaluation of 163 putative cases diagnosed at a single institution over a 48-year period. Am J Surg Pathol. 2010;34:1504–13.

    Article  PubMed  Google Scholar 

  69. Fletcher CD, editor. WHO classification of tumours; pathology and genetics, tumours of soft tissue and bone. Lyon: IARC Press; 2002.

    Google Scholar 

  70. Pachter MR, Lattes R. Mesenchymal tumors of the mediastinum. I. Tumors of fibrous tissue, adipose tissue, smooth muscle, and striated muscle. Cancer. 1963;16:74–94.

    Article  CAS  PubMed  Google Scholar 

  71. Barua NR, Patel AR, Takita H, et al. Fibrosarcoma of the mediastinum. J Surg Oncol. 1979;12:11–7.

    Article  CAS  PubMed  Google Scholar 

  72. Baldwin RS. Hypoglycemia associated with fibrosarcoma of mediastinum: review of Doege’s patient. Ann Surg. 1964;160:975–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Doege KW. Fibrosarcoma of the mediastinum. Ann Surg. 1930;92:955–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. Ringertz N, Lidholm SO. Mediastinal tumors and cysts. J Thorac Surg. 1956;31:458–87.

    Article  CAS  PubMed  Google Scholar 

  75. Pescarmona E, Remotti D, Marzullo A, et al. Fibrosarcoma of the thymic region. A case report. Tumori. 1991;77:363–6.

    Article  CAS  PubMed  Google Scholar 

  76. Okubo K, Kuwabara M, Ito K, et al. A case of mediastinal fibrosarcoma. Nihon Kyobu Geka Gakkai Zasshi. 1995;43:221–5.

    CAS  PubMed  Google Scholar 

  77. Yamazaki F, Nakatani F, Asano N, et al. Novel NTRK3 fusions in fibrosarcomas of adults. Am J Surg Pathol. 2019;43(4):523–30.

    Article  PubMed  Google Scholar 

  78. Montgomery E, Fisher C. Myofibroblastic differentiation in malignant fibrous histiocytoma (pleomorphic myofibrosarcoma): a clinicopathological study. Histopathology. 2001;38:499–509.

    Article  CAS  PubMed  Google Scholar 

  79. Goldblum JR. An approach to pleomorphic sarcomas: can we subclassify, and does it matter? Mod Pathol. 2014;S1:S39–46.

    Article  Google Scholar 

  80. Imai K, Saito H, Minamiya Y, et al. Malignant fibrous histiocytoma originating from the thymus. Gen Thorac Cardiovasc Surg. 2008;56:606–9.

    Article  PubMed  Google Scholar 

  81. Hernandez A, Gill FI, Aventura E, et al. Mediastinal pleomorphic sarcoma in an immunodeficient patient: case report and review of the literature. J La State Med Soc. 2012;164:21–5.

    PubMed  Google Scholar 

  82. Murakawa T, Nakajima J, Fukami T, et al. Malignant fibrous histiocytoma in the anterior mediastinum. Jpn J Thorac Cardiovasc Surg. 2001;49:722–7.

    Article  CAS  PubMed  Google Scholar 

  83. Shimizu J, Murakami S, Oda M, et al. Malignant fibrous histiocytoma originating in the mediastinum: report of a case. Surg Today. 1994;24:368–70.

    Article  CAS  PubMed  Google Scholar 

  84. Kasahara D, Masuda R, Tanaka I, et al. Inflammatory type of malignant fibrous histiocytoma in the anterior mediastinum–a case report. Nihon Kyobu Geka Gakkai Zasshi. 1991;39:366–72.

    CAS  PubMed  Google Scholar 

  85. Carneiro A, Francis P, Bendahl PO, et al. Indistinguishable genomic profiles and shared prognostic markers in undifferentiated pleomorphic sarcoma and leiomyosarcoma: different sides of a single coin? Lab Investig. 2009;89:668–75.

    Article  CAS  PubMed  Google Scholar 

  86. Sultan I, Rodriguez-Galindo C, Saab R, et al. Comparing children and adults with synovial sarcoma in the Surveillance, Epidemiology, and End Results program, 1983 to 2005: an analysis of 1268 patients. Cancer. 2009;115:3537–47.

    Article  PubMed  Google Scholar 

  87. Terra SB, Aesif SW, Maleszewski JJ, et al. Mediastinal synovial sarcoma: clinicopathologic analysis of 21 cases with molecular confirmation. Am J Surg Pathol. 2018;42:761–6.

    Article  PubMed  Google Scholar 

  88. Fisher C. Synovial sarcoma: ultrastructural and immunohistochemical features of epithelial differentiation in monophasic and biphasic tumors. Hum Pathol. 1986;17:996–1008.

    Article  CAS  PubMed  Google Scholar 

  89. Dickersin GR. Synovial sarcoma: a review and update, with emphasis on the ultrastructural characterization of the non-glandular component. Ultrastruct Pathol. 1991;15:379–402.

    Article  CAS  PubMed  Google Scholar 

  90. Salah S, Salem A. Primary synovial sarcomas of the mediastinum: a systematic review and pooled analysis of the published literature. ISRN Oncol. 2014;2014:412527.

    PubMed  PubMed Central  Google Scholar 

  91. Suster S, Moran CA. Primary synovial sarcomas of the mediastinum: a clinicopathologic, immunohistochemical, and ultrastructural study of 15 cases. Am J Surg Pathol. 2005;29:569–78.

    Article  PubMed  Google Scholar 

  92. Lan T, Chen H, Xiong B, et al. Primary pleuropulmonary and mediastinal synovial sarcoma: a clinicopathologic and molecular study of 26 genetically confirmed cases in the largest institution of southwest China. Diagn Pathol. 2016;11:62.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  93. Baheti AD, Sewatkar R, Hornick JL, et al. Imaging features of primary and recurrent intrathoracic synovial sarcoma: a single-institute experience. Clin Imaging. 2015;39:803–8.

    Article  PubMed  Google Scholar 

  94. Deshmukh R, Mankin HJ, Singer S. Synovial sarcoma: the importance of size and location for survival. Clin Orthop Relat Res. 2004;419:155–61.

    Article  Google Scholar 

  95. Ulmer C, Kettelhack C, Tunn PU, et al. Synovial sarcoma of the extremities. Results of surgical and multimodal therapy. Chirurg. 2003;74:370–4.

    Article  CAS  PubMed  Google Scholar 

  96. Eilber FC, Brennan MF, Eilber FR, et al. Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma. Ann Surg. 2007;246:105–13.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Trassard M, Le Doussal V, Hacène K, et al. Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients. J Clin Oncol. 2001;19:525–34.

    Article  CAS  PubMed  Google Scholar 

  98. Pelmus M, Guillou L, Hostein I, et al. Monophasic fibrous and poorly differentiated synovial sarcoma: immunohistochemical reassessment of 60 t(X;18)(SYT-SSX)-positive cases. Am J Surg Pathol. 2002;26:1434–40.

    Article  PubMed  Google Scholar 

  99. Miettinen M, Limon J, Niezabitowski A, et al. Calretinin and other mesothelioma markers in synovial sarcoma: analysis of antigenic similarities and differences with malignant mesothelioma. Am J Surg Pathol. 2001;25:610–7.

    Article  CAS  PubMed  Google Scholar 

  100. Foo WC, Cruise MW, Wick MR, et al. Immunohistochemical staining for TLE1 distinguishes synovial sarcoma from histologic mimics. Am J Clin Pathol. 2011;135:839–44.

    Article  PubMed  Google Scholar 

  101. Olsen SH, Thomas DG, Lucas DR. Cluster analysis of immunohistochemical profiles in synovial sarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma. Mod Pathol. 2006;19:659–68.

    Article  CAS  PubMed  Google Scholar 

  102. Przybyl J, Sciot R, Rutkowski P, et al. Recurrent and novel SS18-SSX fusion transcripts in synovial sarcoma: description of three new cases. Tumour Biol. 2012;33:2245–53.

    Article  CAS  PubMed  Google Scholar 

  103. Srinivasan R, Gautam U, Gupta R, et al. Synovial sarcoma: diagnosis on fine-needle aspiration by morphology and molecular analysis. Cancer. 2009;117:128–36.

    CAS  PubMed  Google Scholar 

  104. Eilber FC, Tap WD, Nelson SD, et al. Advances in chemotherapy for patients with extremity soft tissue sarcoma. Orthop Clin North Am. 2006;37:15–22.

    Article  PubMed  Google Scholar 

  105. Turc-Carel C, Dal Cin P, Limon J, et al. Translocation X;18 in synovial sarcoma. Cancer Genet Cytogenet. 1986;23:93.

    Article  CAS  PubMed  Google Scholar 

  106. Niwa H, Kondou K, Sekiguchi K. A case of mediastinal leiomyoma associated with cystic change and calcification–a review of 7 cases in Japanese literatures. Nihon Kyobu Geka Gakkai Zasshi. 1988;36:2136–9.

    CAS  PubMed  Google Scholar 

  107. Ouadnouni Y, Achir A, Bekarsabein S, et al. Primary mediastinal leiomyoma: a case report. Cases J. 2009;2:8555.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Li C, Lin F, Pu Q, et al. Primary mediastinal leiomyoma: a rare case report and literature review. J Thorac Dis. 2018;10:E116–9.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Hakeem ZA, Rathore SS, Wahid A. Rare mediastinal leiomyoma in a child. Gen Thorac Cardiovasc Surg. 2017;65:415–7.

    Article  PubMed  Google Scholar 

  110. Baldó X, Sureda C, Gimferrer JM, et al. Primary mediastinal leiomyoma: an angiographic study and embolisation of the feeding vessels to improve the surgical approach. Eur J Cardiothorac Surg. 1997;11:574–6.

    Article  PubMed  Google Scholar 

  111. Uno A, Sakurai M, Onuma K, et al. A case of giant mediastinal leiomyoma with long-term survival. Tohoku J Exp Med. 1988;156:1–6.

    Article  CAS  PubMed  Google Scholar 

  112. Shaffer K, Pugatch RD, Sugarbaker DJ. Primary mediastinal leiomyoma. Ann Thorac Surg. 1990;50:301–2.

    Article  CAS  PubMed  Google Scholar 

  113. Mehine M, Mäkinen N, Heinonen HR, et al. Genomics of uterine leiomyomas: insights from high-throughput sequencing. Fertil Steril. 2014;102:621–9.

    Article  CAS  PubMed  Google Scholar 

  114. Eroğlu A, Kürkçüoğlu C, Karaoğlanoğlu N, et al. Primary leiomyosarcoma of the anterior mediastinum. Eur J Cardiothorac Surg. 2002;21:943–5.

    Article  PubMed  Google Scholar 

  115. Contreras AL, Punar M, Tamboli P, et al. Mediastinal germ cell tumors with an angiosarcomatous component: a report of 12 cases. Hum Pathol. 2010;41:832–7.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Moran CA, Suster S, Perino G, et al. Malignant smooth muscle tumors presenting as mediastinal soft tissue masses. A clinicopathologic study of 10 cases. Cancer. 1994;74:2251–60.

    Article  CAS  PubMed  Google Scholar 

  117. Hirano H, Kizaki T, Sashikata T, et al. Leiomyosarcoma arising from soft tissue tumor of the mediastinum. Med Electron Microsc. 2003;36:52–8.

    Article  PubMed  Google Scholar 

  118. Sunderrajan EV, Luger AM, Rosenholtz MJ, et al. Leiomyosarcoma in the mediastinum presenting as superior vena cava syndrome. Cancer. 1984;53:2553–6.

    Article  CAS  PubMed  Google Scholar 

  119. Lincoln JC. Leiomyosarcoma of the anterior mediastinum. Thorax. 1965;20:362–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  120. Vaziri M. Primary mediastinal leiomyosarcoma. Gen Thorac Cardiovasc Surg. 2012;60:522–4.

    Article  PubMed  Google Scholar 

  121. Villacis RA, Silveira SM, Barros-Filho MC, et al. Gene expression profiling in leiomyosarcomas and undifferentiated pleomorphic sarcomas: SRC as a new diagnostic marker. PLoS One. 2014;9:e102281.

    Article  PubMed  PubMed Central  Google Scholar 

  122. Suster S, Moran CA, Koss MN. Rhabdomyosarcomas of the anterior mediastinum: report of four cases unassociated with germ cell, teratomatous, or thymic carcinomatous components. Hum Pathol. 1994;25:349–56.

    Article  CAS  PubMed  Google Scholar 

  123. Qi Y, Chang B, Pang L, et al. Solid alveolar rhabdomyosarcoma with spindle-shaped cells and epithelial differentiation of the mediastinum in a 68-year-old man: a case report and literature review. J Cancer Res Ther. 2011;7:353–6.

    Article  PubMed  Google Scholar 

  124. Gladish GW, Sabloff BM, Munden RF, et al. Primary thoracic sarcomas. Radiographics. 2002;22:621–37.

    Article  PubMed  Google Scholar 

  125. Missiaglia E, Shepherd CJ, Patel S, et al. MicroRNA-206 expression levels correlate with clinical behaviour of rhabdomyosarcomas. Br J Cancer. 2010;102:1769–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  126. Horn RC Jr, Enterline HT. Rhabdomyosarcoma: a clinicopathological study and classification of 39 cases. Cancer. 1958;11:181–99.

    Article  PubMed  Google Scholar 

  127. Kumar S, Perlman E, Harris CA, et al. Myogenin is a specific marker for rhabdomyosarcoma: an immunohistochemical study in paraffin-embedded tissues. Mod Pathol. 2000;13:988–93.

    Article  CAS  PubMed  Google Scholar 

  128. Cessna MH, Zhou H, Perkins SL, et al. Are myogenin and myoD1 expression specific for rhabdomyosarcoma? A study of 150 cases, with emphasis on spindle cell mimics. Am J Surg Pathol. 2001;25:1150–7.

    Article  CAS  PubMed  Google Scholar 

  129. Morotti RA, Nicol KK, Parham DM, et al; Children’s Oncology Group. An immunohistochemical algorithm to facilitate diagnosis and subtyping of rhabdomyosarcoma: the Children’s Oncology Group experience. Am J Surg Pathol. 2006;30:962–8.

    Google Scholar 

  130. Rekhi B, Gupta C, Chinnaswamy G, et al. Clinicopathologic features of 300 rhabdomyosarcomas with emphasis upon differential expression of skeletal muscle specific markers in the various subtypes: a single institutional experience. Ann Diagn Pathol. 2018;36:50–60.

    Article  PubMed  Google Scholar 

  131. Bahrami A, Gown AM, Baird GS, et al. Aberrant expression of epithelial and neuroendocrine markers in alveolar rhabdomyosarcoma: a potentially serious diagnostic pitfall. Mod Pathol. 2008;21:795–806.

    Article  CAS  PubMed  Google Scholar 

  132. Kelly KM, Womer RB, Sorensen PH, et al. Common and variant gene fusions predict distinct clinical phenotypes in rhabdomyosarcoma. J Clin Oncol. 1997;15:1831–6.

    Article  CAS  PubMed  Google Scholar 

  133. Wallace WA, Dorward DA, Salter DM. Immunohistochemistry for small-cell carcinoma: a potential diagnostic pitfall. Histopathology. 2019;74(5):792–4.

    Article  PubMed  Google Scholar 

  134. Ratto GB, Costa R, Alloisio A, et al. Mediastinal chondrosarcoma. Tumori. 2004;90:151–3.

    Article  PubMed  Google Scholar 

  135. Montresor E, Abrescia F, Bertrand C, et al. Mediastinal chondrosarcoma. Case report. Acta Chir Scand. 1990;156:733–6.

    CAS  PubMed  Google Scholar 

  136. Suster S, Moran CA. Malignant cartilaginous tumors of the mediastinum: clinicopathological study of six cases presenting as extraskeletal soft tissue masses. Hum Pathol. 1997;28:588–94.

    Article  CAS  PubMed  Google Scholar 

  137. Chetty R. Extraskeletal mesenchymal chondrosarcoma of the mediastinum. Histopathology. 1990;17:261–3.

    Article  CAS  PubMed  Google Scholar 

  138. Lichtenstein L, Bernstein D. Unusual benign and malignant chondroid tumors of bone. A survey of some mesenchymal cartilage tumors and malignant chondroblastic tumors, including a few multicentric ones, as well as many atypical benign chondroblastomas and chondromyxoid fibromas. Cancer. 1959;12:1142–57.

    Article  Google Scholar 

  139. Jeong SS, Choi PJ, Kim DW, et al. Primary extraskeletal mesenchymal chondrosarcoma of the anterior mediastinum. Korean J Pathol. 2013;47:492–4.

    Article  PubMed  PubMed Central  Google Scholar 

  140. Jindal T, Chaudhary R, Sharma N, et al. Primary mediastinal chondrosarcoma with Horner’s syndrome. Gen Thorac Cardiovasc Surg. 2011;59:145–7.

    Article  PubMed  Google Scholar 

  141. Dahlin DC, Beabout JW. Dedifferentiation of low-grade chondrosarcomas. Cancer. 1971;28:461–6.

    Article  CAS  PubMed  Google Scholar 

  142. Nakashima Y, Unni KK, Shives TC, et al. Mesenchymal chondrosarcoma of bone and soft tissue. A review of 111 cases. Cancer. 1986;57:2444–53.

    Article  CAS  PubMed  Google Scholar 

  143. Wang L, Motoi T, Khanin R, et al. Identification of a novel, recurrent HEY1-NCOA2 fusion in mesenchymal chondrosarcoma based on a genome-wide screen of exon-level expression data. Genes Chromosomes Cancer. 2012;51:127–39.

    Article  CAS  PubMed  Google Scholar 

  144. Ogura K, Fujiwara T, Beppu Y, et al. Extraskeletal myxoid chondrosarcoma: a review of 23 patients treated at a single referral center with long-term follow-up. Arch Orthop Trauma Surg. 2012;132:1379–86.

    Article  PubMed  Google Scholar 

  145. Hishida T, Yoshida J, Nishimura M, et al. Extraskeletal osteosarcoma arising in anterior mediastinum: brief report with a review of the literature. J Thorac Oncol. 2009;4:927–9.

    Article  PubMed  Google Scholar 

  146. McCarter MD, Lewis JJ, Antonescu CR, et al. Extraskeletal osteosarcoma: analysis of outcome of a rare neoplasm. Sarcoma. 2000;4:119–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  147. Lee JS, Fetsch JF, Wasdhal DA, et al. A review of 40 patients with extraskeletal osteosarcoma. Cancer. 1995;76:2253–9.

    Article  CAS  PubMed  Google Scholar 

  148. Catanese J, Dutcher JP, Dorfman HD, et al. Mediastinal osteosarcoma with extension to lungs in a patient treated for Hodgkin’s disease. Cancer. 1988;62:2252–7.

    Article  CAS  PubMed  Google Scholar 

  149. Qian J, Zhang XY, Gu P, et al. Primary thoracic extraskeletal osteosarcoma: a case report and literature review. J Thorac Dis. 2017;9:E1088–95.

    Article  PubMed  PubMed Central  Google Scholar 

  150. Fanburg-Smith JC, Bratthauer GL, Miettinen M. Osteocalcin and osteonectin immunoreactivity in extraskeletal osteosarcoma: a study of 28 cases. Hum Pathol. 1999;30:32–8.

    Article  CAS  PubMed  Google Scholar 

  151. Conner JR, Hornick JL. SATB2 is a novel marker of osteoblastic differentiation in bone and soft tissue tumours. Histopathology. 2013;63:36–49.

    Article  PubMed  Google Scholar 

  152. Guillou L, Aurias A. Soft tissue sarcomas with complex genomic profiles. Virchows Arch. 2010;456:201–17.

    Article  CAS  PubMed  Google Scholar 

  153. Sakurai H, Kaji M, Yamazaki K, et al. Intrathoracic lipomas: their clinicopathological behaviors are not as straightforward as expected. Ann Thorac Surg. 2008;86:261–5.

    Article  PubMed  Google Scholar 

  154. Marreez YM, Roy W, Roque R, et al. The rare mediastinal lipoma: a postmortem case report. Int J Clin Exp Pathol. 2012;5:991–5.

    PubMed  PubMed Central  Google Scholar 

  155. Mahomed AA, Beale P, Puri P. Mediastinal lipoma in children. Pediatr Surg Int. 1998;13:218–9.

    Article  CAS  PubMed  Google Scholar 

  156. Kato M, Saji S, Kunieda K, et al. Mediastinal lipoma: report of a case. Surg Today. 1997;27:766–8.

    Article  CAS  PubMed  Google Scholar 

  157. Shub C, Parkin TW, Lie JT. An unusual mediastinal lipoma simulating cardiomegaly. Mayo Clin Proc. 1979;54:60–2.

    CAS  PubMed  Google Scholar 

  158. Gaerte SC, Meyer CA, Winer-Muram HT, et al. Fat-containing lesions of the chest. Radiographics. 2002;22:S61–78.

    Article  PubMed  Google Scholar 

  159. Jack AI, Blohm ME, Lye M. An intrathoracic lipoma impairing left ventricular function. Br Heart J. 1995;74:95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  160. Jain V, Singal AK, Gupta AK, et al. Transmural intrathoracic lipoma with intraspinal extension. J Pediatr Surg. 2007;42:2120–2.

    Article  PubMed  Google Scholar 

  161. Politis J, Funahashi A, Gehlsen JA, et al. Intrathoracic lipomas. Report of three cases and review of the literature with emphasis on endobronchial lipoma. J Thorac Cardiovasc Surg. 1979;77:550–6.

    Article  CAS  PubMed  Google Scholar 

  162. Moran CA, Rosado-de-Christenson M, Suster S. Thymolipoma: clinicopathologic review of 33 cases. Mod Pathol. 1995;8:741–4.

    CAS  PubMed  Google Scholar 

  163. Kline ME, Patel BU, Agosti SJ. Noninfiltrating angiolipoma of the mediastinum. Radiology. 1990;175:737–8.

    Article  CAS  PubMed  Google Scholar 

  164. Oaks J, Margolis DJ. Spindle cell lipoma of the mediastinum: a differential consideration for liposarcoma. J Thorac Imaging. 2007;22:355–7.

    Article  PubMed  Google Scholar 

  165. Baldi A, Santini M, Mellone P, et al. Mediastinal hibernoma: a case report. J Clin Pathol. 2004;57:993–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  166. Gao B, Sugimura H, Sugimura S, et al. Mediastinal myelolipoma. Asian Cardiovasc Thorac Ann. 2002;10:189–90.

    Article  PubMed  Google Scholar 

  167. Evans HL. Liposarcoma: a study of 55 cases with a reassessment of its classification. Am J Surg Pathol. 1979;3:507–23.

    Article  CAS  PubMed  Google Scholar 

  168. Kindblom LG, Angervall L, Svendsen P. Liposarcoma a clinicopathologic, radiographic and prognostic study. Acta Pathol Microbiol Scand Suppl. 1975:1–71.

    Google Scholar 

  169. Schweitzer DL, Aguam AS. Primary liposarcoma of the mediastinum. Report of a case and review of the literature. J Thorac Cardiovasc Surg. 1977;74:83–9ef7.

    Article  CAS  PubMed  Google Scholar 

  170. Cicciarelli FE, Soule EH, McGoon DC. Lipoma and liposarcoma of the mediastinum: a report of 14 tumors including one lipoma of the thymus. J Thorac Cardiovasc Surg. 1964;47:411–29.

    Article  CAS  PubMed  Google Scholar 

  171. Klimstra DS, Moran CA, Perino G, et al. Liposarcoma of the anterior mediastinum and thymus. A clinicopathologic study of 28 cases. Am J Surg Pathol. 1995;19:782–91.

    Article  CAS  PubMed  Google Scholar 

  172. Boland JM, Colby TV, Folpe AL. Liposarcomas of the mediastinum and thorax: a clinicopathologic and molecular cytogenetic study of 24 cases, emphasizing unusual and diverse histologic features. Am J Surg Pathol. 2012;36:1395–403.

    Article  PubMed  Google Scholar 

  173. Ortega P, Suster D, Falconieri G, et al. Liposarcomas of the posterior mediastinum: clinicopathologic study of 18 cases. Mod Pathol. 2015;28:721–31.

    Article  CAS  PubMed  Google Scholar 

  174. Chen M, Yang J, Zhu L, et al. Primary intrathoracic liposarcoma: a clinicopathologic study and prognostic analysis of 23 cases. J Cardiothorac Surg. 2014;9:119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  175. Miura K, Hamanaka K, Matsuoka S, et al. Primary mediastinal dedifferentiated liposarcoma: five case reports and a review. Thorac Cancer. 2018;9:1733–40.

    Article  PubMed  PubMed Central  Google Scholar 

  176. Hirai S, Hamanaka Y, Mitsui N, et al. Surgical resection of primary liposarcoma of the anterior mediastinum. Ann Thorac Cardiovasc Surg. 2008;14:38–41.

    PubMed  Google Scholar 

  177. Suster S, Wong TY, Moran CA. Sarcomas with combined features of liposarcoma and leiomyosarcoma. Study of two cases of an unusual soft-tissue tumor showing dual lineage differentiation. Am J Surg Pathol. 1993;17:905–11.

    Article  CAS  PubMed  Google Scholar 

  178. Weissferdt A, Moran CA. Lipomatous tumors of the anterior mediastinum with muscle differentiation: a clinicopathological and immunohistochemical study of three cases. Virchows Arch. 2014;464:489–93.

    Article  PubMed  Google Scholar 

  179. Hashimoto H, Daimaru Y, Enjoji M. S-100 protein distribution in liposarcoma. An immunoperoxidase study with special reference to the distinction of liposarcoma from myxoid malignant fibrous histiocytoma. Virchows Arch A Pathol Anat Histopathol. 1984;405:1–10.

    Article  CAS  PubMed  Google Scholar 

  180. Pedeutour F, Suijkerbuijk RF, Forus A, et al. Complex composition and co-amplification of SAS and MDM2 in ring and giant rod marker chromosomes in well-differentiated liposarcoma. Genes Chromosomes Cancer. 1994;10:85–94.

    Article  CAS  PubMed  Google Scholar 

  181. Pedeutour F, Forus A, Coindre JM, et al. Structure of the supernumerary ring and giant rod chromosomes in adipose tissue tumors. Genes Chromosomes Cancer. 1999;24:30–41.

    Article  CAS  PubMed  Google Scholar 

  182. Rosai J, Akerman M, Dal Cin P, et al. Combined morphologic and karyotypic study of 59 atypical lipomatous tumors. Evaluation of their relationship and differential diagnosis with other adipose tissue tumors (a report of the CHAMP Study Group). Am J Surg Pathol. 1996;20:1182–9.

    Article  CAS  PubMed  Google Scholar 

  183. Mandahl N, Höglund M, Mertens F, et al. Cytogenetic aberrations in 188 benign and borderline adipose tissue tumors. Genes Chromosomes Cancer. 1994;9:207–15.

    Article  CAS  PubMed  Google Scholar 

  184. Pilotti S, Della Torre G, Lavarino C, et al. Distinct MDM2/p53 expression patterns in liposarcoma subgroups: implications for different pathogenetic mechanisms. J Pathol. 1997;181:14–24.

    Article  CAS  PubMed  Google Scholar 

  185. Pilotti S, Della Torre G, Lavarino C, et al. Molecular abnormalities in liposarcoma: role of MDM2 and CDK4-containing amplicons at 12q13-22. J Pathol. 1998;185:188–90.

    Article  CAS  PubMed  Google Scholar 

  186. Dei Tos AP, Doglioni C, Piccinin S, et al. Coordinated expression and amplification of the MDM2, CDK4, and HMGI-C genes in atypical lipomatous tumours. J Pathol. 2000;190:531–6.

    Article  CAS  PubMed  Google Scholar 

  187. Crozat A, Aman P, Mandahl N, et al. Fusion of CHOP to a novel RNA-binding protein in human myxoid liposarcoma. Nature. 1993;363:640–4.

    Article  CAS  PubMed  Google Scholar 

  188. Turc-Carel C, Limon J, Dal Cin P, et al. Cytogenetic studies of adipose tissue tumors. II. Recurrent reciprocal translocation t(12;16)(q13;p11) in myxoid liposarcomas. Cancer Genet Cytogenet. 1986;23:291–9.

    Article  CAS  PubMed  Google Scholar 

  189. Idbaih A, Coindre JM, Derré J, et al. Myxoid malignant fibrous histiocytoma and pleomorphic liposarcoma share very similar genomic imbalances. Lab Investig. 2005;85:176–81.

    Article  CAS  PubMed  Google Scholar 

  190. Shimada S, Ishizawa T, Ishizawa K, et al. The value of MDM2 and CDK4 amplification levels using real-time polymerase chain reaction for the differential diagnosis of liposarcomas and their histologic mimickers. Hum Pathol. 2006;37:1123–9.

    Article  CAS  PubMed  Google Scholar 

  191. Takeda S, Miyoshi S, Minami M, et al. Intrathoracic neurogenic tumors–50 years’ experience in a Japanese institution. Eur J Cardiothorac Surg. 2004;24:807–12.

    Google Scholar 

  192. Aughenbaugh GL. Thoracic manifestations of neurocutaneous diseases. Radiol Clin N Am. 1984;22:741–56.

    CAS  PubMed  Google Scholar 

  193. Reed JC, Hallet KK, Feigin DS. Neural tumors of the thorax: subject review from the AFIP. Radiology. 1978;126:9–17.

    Article  CAS  PubMed  Google Scholar 

  194. Swanson PE. Soft tissue neoplasma of the mediastinum. Semin Diagn Pathol. 1991;8:14–34.

    CAS  PubMed  Google Scholar 

  195. Hosoi K. Multiple neurofibromatosis (von Recklinghausen’s disease): with special reference to malignant transformation. Arch Surg. 1931;22:258–81.

    Article  Google Scholar 

  196. Gale AW, Jelihovsky T, Grant AF, et al. Neurogenic tumors of the mediastinum. Ann Thorac Surg. 1974;17:434–43.

    Article  CAS  PubMed  Google Scholar 

  197. Akwari OE, Payne WS, Onofrio BM, et al. Dumbbell neurogenic tumors of the mediastinum. Diagnosis and management. Mayo Clin Proc. 1978;53:353–8.

    CAS  PubMed  Google Scholar 

  198. Pavlus JD, Carter BW, Tolley MD, et al. Imaging of thoracic neurogenic tumors. AJR Am J Roentgenol. 2016;207:552–61.

    Article  PubMed  Google Scholar 

  199. Woo OH, Yong HS, Shin BK, et al. Wide spectrum of thoracic neurogenic tumours: a pictorial review of CT and pathological findings. Br J Radiol. 2008;81:668–76.

    Article  CAS  PubMed  Google Scholar 

  200. Bourgouin PM, Shepard JO, Moore EH, et al. Plexiform neurofibromatosis of the mediastinum: CT appearance. AJR Am J Roentgenol. 1988;151:461–3.

    Article  CAS  PubMed  Google Scholar 

  201. Shields TW, Reynolds M. Neurogenic tumors of the thorax. Surg Clin North Am. 1988;68:645–68.

    Article  CAS  PubMed  Google Scholar 

  202. Ribet ME, Cardot GR. Neurogenic tumors of the thorax. Ann Thorac Surg. 1994;58:1091–5.

    Article  CAS  PubMed  Google Scholar 

  203. Pachter MR, Lattes R. Neurogenous tumors of the mediastinum: a clinicopathologic study based on 50 cases. Dis Chest. 1963;44:79–87.

    Article  CAS  PubMed  Google Scholar 

  204. Kumar AJ, Kuhajda FP, Martinez CR, et al. Computed tomography of extracranial nerve sheath tumors with pathological correlation. J Comput Assist Tomogr. 1983;7:857–65.

    Article  CAS  PubMed  Google Scholar 

  205. Rodriguez FJ, Folpe AL, Giannini C, et al. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol. 2012;123:295–319.

    Article  PubMed  PubMed Central  Google Scholar 

  206. Wallace MR, Marchuk DA, Andersen LB, Letcher R, Odeh HM, Saulino AM, Fountain JW, Brereton A, Nicholson J, Mitchell AL, et al. Type 1 neurofibromatosis gene: identification of a large transcript disrupted in three NF1 patients. Science. 1990;249:181–6.

    Article  CAS  PubMed  Google Scholar 

  207. Lichtenberger JP 3rd, Carter BW, Abbott GF. Pitfalls in imaging of the chest wall. Semin Roentgenol. 2015;50:251–7.

    Article  PubMed  Google Scholar 

  208. Boland JM, Colby TV, Folpe AL. Intrathoracic peripheral nerve sheath tumors-a clinicopathological study of 75 cases. Hum Pathol. 2015;46:419–25.

    Article  PubMed  Google Scholar 

  209. Geniets C, Vanhoenacker FM, Simoens W, Gielen J, De Schepper AM, Parizel PM. Imaging features of peripheral neurogenic tumors. JBR-BTR. 2006;89:216–9.

    CAS  PubMed  Google Scholar 

  210. Subhawong TK, Fishman EK, Swart JE, Carrino JA, Attar S, Fayad LM. Soft-tissue masses and masslike conditions: what does CT add to diagnosis and management? AJR Am J Roentgenol. 2010;194:1559–67.

    Article  PubMed  PubMed Central  Google Scholar 

  211. Lin J, Martel W. Cross-sectional imaging of peripheral nerve sheath tumors: characteristic signs on CT, MR imaging, and sonography. AJR Am J Roentgenol. 2001;176:75–82.

    Article  CAS  PubMed  Google Scholar 

  212. Fletcher CD, Davies SE, McKee PH. Cellular schwannoma: a distinct pseudosarcomatous entity. Histopathology. 1987;11:21–35.

    Article  CAS  PubMed  Google Scholar 

  213. Woodruff JM, Godwin TA, Erlandson RA, Susin M, Martini N. Cellular schwannoma: a variety of schwannoma sometimes mistaken for a malignant tumor. Am J Surg Pathol. 1981;5:733–44.

    Article  CAS  PubMed  Google Scholar 

  214. Torres-Mora J, Dry S, Li X, Binder S, Amin M, Folpe AL. Malignant melanotic schwannian tumor: a clinicopathologic, immunohistochemical, and gene expression profiling study of 40 cases, with a proposal for the reclassification of “melanotic schwannoma”. Am J Surg Pathol. 2014;38:94–105.

    Article  PubMed  Google Scholar 

  215. Park JY, Park NJ, Kim SP, Kwon KY, Lee SS. A soft tissue perineurioma and a hybrid tumor of perineurioma and schwannoma. Korean J Pathol. 2012;46:75–8.

    Article  PubMed  PubMed Central  Google Scholar 

  216. Stefansson K, Wollmann R, Jerkovic M. S-100 protein in soft-tissue tumors derived from Schwann cells and melanocytes. Am J Pathol. 1982;106:261–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  217. Striedinger K, VandenBerg SR, Baia GS, McDermott MW, Gutmann DH, Lal A. The neurofibromatosis 2 tumor suppressor gene product, merlin, regulates human meningioma cell growth by signaling through YAP. Neoplasia. 2008;10:1204–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  218. Hanemann CO, Evans DG. News on the genetics, epidemiology, medical care and translational research of schwannomas. J Neurol. 2006;253:1533–41.

    Article  CAS  PubMed  Google Scholar 

  219. Soh WM, Yeong ML, Wong KP. Malignant granular cell tumour of the mediastinum. Malays J Pathol. 2014;36:149–51.

    PubMed  Google Scholar 

  220. De Luca G, Luciano A, Benincasa G, et al. Giant malignant granular cell tumor (GCT) of the posterior mediastinum. J Thorac Oncol. 2013;8:1107–8.

    Article  PubMed  Google Scholar 

  221. Ordóñez NG, Mackay B. Granular cell tumor: a review of the pathology and histogenesis. Ultrastruct Pathol. 1999;23:207–22.

    Article  PubMed  Google Scholar 

  222. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol. 1998;22:779–94.

    Article  CAS  PubMed  Google Scholar 

  223. Marchevsky AM. Mediastinal tumors of peripheral nervous system origin. Semin Diagn Pathol. 1999;16:65–78.

    CAS  PubMed  Google Scholar 

  224. Machida E, Haniuda M, Eguchi T, et al. Granular cell tumor of the mediastinum. Intern Med. 2003;42:178–81.

    Article  PubMed  Google Scholar 

  225. Aisner SC, Chakravarthy AK, Joslyn JN, et al. Bilateral granular cell tumors of the posterior mediastinum. Chest. 1972;61:95–6.

    Article  Google Scholar 

  226. Harrer WV, Patchefsky AS. Malignant granular-cell myoblastoma of the posterior mediastinum. Chest. 1972;61:95–6.

    Article  CAS  PubMed  Google Scholar 

  227. Winchester LM, Puckett Y, Greenspon J, et al. Mediastinal granular cell tumor in a 16-year-old boy: a surgical and pathologic perspective. Pediatr Dev Pathol. 2016;19:64–8.

    Article  PubMed  Google Scholar 

  228. D’hulst L, Deroose C, Strybol D, et al. 18F-FDG PET/CT and MRI of a mediastinal malignant granular cell tumor with associated recurrent pericarditis. Clin Nucl Med. 2018;43:589–90.

    Article  PubMed  Google Scholar 

  229. Chamberlain BK, McClain CM, Gonzalez RS, et al. Alveolar soft part sarcoma and granular cell tumor: an immunohistochemical comparison study. Hum Pathol. 2014;45:1039–44.

    Article  CAS  PubMed  Google Scholar 

  230. Ducatman BS, Scheithauer BW, Piepgras DG, et al. Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases. Cancer. 1986;57:2006–21.

    Article  CAS  PubMed  Google Scholar 

  231. Pekmezci M, Reuss DE, Hirbe AC, et al. Morphologic and immunohistochemical features of malignant peripheral nerve sheath tumors and cellular schwannomas. Mod Pathol. 2015;28:187–200.

    Article  CAS  PubMed  Google Scholar 

  232. Koezuka S, Hata Y, Sato F, et al. Malignant peripheral nerve sheath tumor in the anterior mediastinum: a case report. Mol Clin Oncol. 2014;2:987–90.

    Article  PubMed  PubMed Central  Google Scholar 

  233. Thway K, Fisher C. Malignant peripheral nerve sheath tumor: pathology and genetics. Ann Diagn Pathol. 2014;18:109–16.

    Article  PubMed  Google Scholar 

  234. Ducatman BS, Scheithauer BW. Malignant peripheral nerve sheath tumors with divergent differentiation. Cancer. 1984;54:1049–57.

    Article  CAS  PubMed  Google Scholar 

  235. Stasik CJ, Tawfik O. Malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation (malignant triton tumor). Arch Pathol Lab Med. 2006;130:1878–81.

    Article  PubMed  Google Scholar 

  236. Ren X, Wang J, Hu M, et al. Clinical, radiological, and pathological features of 26 intracranial and intraspinal malignant peripheral nerve sheath tumors. J Neurosurg. 2013;119:695–708.

    Article  PubMed  Google Scholar 

  237. Brooks JS, Freeman M, Enterline HT. Malignant “Triton” tumors. Natural history and immunohistochemistry of nine new cases with literature review. Cancer. 1985;55:2543–9.

    Article  CAS  PubMed  Google Scholar 

  238. McConnell YJ, Giacomantonio CA. Malignant triton tumors–complete surgical resection and adjuvant radiotherapy associated with improved survival. J Surg Oncol. 2012;106:51–6.

    Article  PubMed  Google Scholar 

  239. Cleven AH, Al Sannaa GA, Briaire-de Bruijn I, et al. Loss of H3K27 tri-methylation is a diagnostic marker for malignant peripheral nerve sheath tumors and an indicator for an inferior survival. Mod Pathol. 2016;29:1113.

    Article  PubMed  Google Scholar 

  240. Bura M, Musani V, Cretnik M, et al. Hedgehog-Patched pathway aberrations in a malignant triton tumor case study. Oncol Rep. 2008;20:347–52.

    PubMed  Google Scholar 

  241. Lee JY, Lee KS, Han J, et al. Spectrum of neurogenic tumors in the thorax: CT and pathologic findings. J Comput Assist Tomogr. 1999;23:399–406.

    Article  CAS  PubMed  Google Scholar 

  242. Wick MR, Rosai J. Neuroendocrine neoplasms of the mediastinum. Semin Diagn Pathol. 1991;8:35–51.

    CAS  PubMed  Google Scholar 

  243. Grosfeld JL, Baehner RL. Neuroblastoma: an analysis of 160 cases. World J Surg. 1980;4:29–37.

    Article  CAS  PubMed  Google Scholar 

  244. Argani P, Erlandson RA, Rosai J. Thymic neuroblastoma in adults: report of three cases with special emphasis on its association with the syndrome of inappropriate secretion of antidiuretic hormone. Am J Clin Pathol. 1997;108:537–43.

    Article  CAS  PubMed  Google Scholar 

  245. Page DL, Hough AJ Jr, Gray GF Jr. Diagnosis and prognosis of adrenocortical neoplasms. Arch Pathol Lab Med. 1986;110:993–4.

    CAS  PubMed  Google Scholar 

  246. Adam A, Hochholzer L. Ganglioneuroblastoma of the posterior mediastinum: a clinicopathologic review of 80 cases. Cancer. 1981;47:373–81.

    Article  CAS  PubMed  Google Scholar 

  247. Bar-Ziv J, Nogrady MB. Mediastinal neuroblastoma and ganglioneuroma. The differentiation between primary and secondary involvement on the chest roentgenogram. Am J Roentgenol Radium Therapy, Nucl Med. 1975;125:380–90.

    Article  CAS  Google Scholar 

  248. Papaioannou G, McHugh K. Neuroblastoma in childhood: review and radiological findings. Cancer Imaging. 2005;5:116–27.

    Article  PubMed  PubMed Central  Google Scholar 

  249. Shimada H, Ambros IM, Dehner LP, et al. The international neuroblastoma pathology classification (the Shimada system). Cancer. 1999;86:364–72.

    Article  CAS  PubMed  Google Scholar 

  250. Shimosato Y, Mukai K, Matsuno Y, American Registry of Pathology, Armed Forces Institute of Pathology (US). Tumors of the mediastinum. Washington, DC: American Registry of Pathology in collaboration with the Armed Forces Institute of Pathology; 2010.

    Google Scholar 

  251. Nakajima T, Watanabe S, Sato Y, et al. An immunoperoxidase study of S-100 protein distribution in normal and neoplastic tissues. Am J Surg Pathol. 1982;6:715–27.

    Article  CAS  PubMed  Google Scholar 

  252. Wirnsberger GH, Becker H, Ziervogel K, et al. Diagnostic immunohistochemistry of neuroblastic tumors. Am J Surg Pathol. 1992;16:49–57.

    Article  CAS  PubMed  Google Scholar 

  253. Øra I, Eggert A. Progress in treatment and risk stratification of neuroblastoma: impact on future clinical and basic research. Semin Cancer Biol. 2011;21:217–28.

    Article  PubMed  Google Scholar 

  254. Mossé YP, Laudenslager M, Longo L, et al. Identification of ALK as a major familial neuroblastoma predisposition gene. Nature. 2008;455:930–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  255. Janoueix-Lerosey I, Lequin D, Brugières L, et al. Somatic and germline activating mutations of the ALK kinase receptor in neuroblastoma. Nature. 2008;455:967–70.

    Article  CAS  PubMed  Google Scholar 

  256. Brodeur GM, Seeger RC, Schwab M, et al. Amplification of N-myc in untreated human neuroblastomas correlates with advanced disease stage. Science. 1984;224:1121–4.

    Article  CAS  PubMed  Google Scholar 

  257. Canete A, Gerrard M, Rubie H, Castel V, et al. Poor survival for infants with MYCN-amplified metastatic neuroblastoma despite intensified treatment: the International Society of Paediatric Oncology European Neuroblastoma Experience. J Clin Oncol. 2009;27:1014–9.

    Article  PubMed  Google Scholar 

  258. Seeger RC, Brodeur GM, Sather H, et al. Association of multiple copies of the N-myc oncogene with rapid progression of neuroblastomas. N Engl J Med. 1985;313:1111–6.

    Article  CAS  PubMed  Google Scholar 

  259. Peuchmaur M, d’Amore ES, Joshi VV, et al. Revision of the International Neuroblastoma Pathology Classification: confirmation of favorable and unfavorable prognostic subsets in ganglioneuroblastoma, nodular. Cancer. 2003;98:2274–81.

    Article  PubMed  Google Scholar 

  260. Askin FB, Rosai J, Sibley RK, et al. Malignant small cell tumor of the thoracopulmonary region in childhood: a distinctive clinicopathologic entity of uncertain histogenesis. Cancer. 1979;43:2438–51.

    Article  CAS  PubMed  Google Scholar 

  261. Halefoglu AM. Extraskeletal Ewing’s sarcoma presenting as a posterior mediastinal mass. Arch Bronconeumol. 2013;49:82–4.

    Article  PubMed  Google Scholar 

  262. Manduch M, Dexter DF, Ellis PM, et al. Extraskeletal Ewing’s sarcoma/primitive neuroectodermal tumor of the posterior mediastinum with t(11;22)(q24;q12). Tumori. 2008;94:888–91.

    Article  PubMed  Google Scholar 

  263. Halliday J, Soon SY, Monaghan H, et al. Extraskeletal Ewing’s sarcoma presenting as a mediastinal mass. Ann Thorac Surg. 2010;90:1016–7.

    Article  PubMed  Google Scholar 

  264. Reali A, Mortellaro G, Allis S, et al. A case of primary mediastinal Ewing’s sarcoma/primitive neuroectodermal tumor presenting with initial compression of superior vena cava. Ann Thorac Med. 2013;8:121–3.

    Article  PubMed  PubMed Central  Google Scholar 

  265. Romano R, Cesario A, Lococo F, et al. Successful multidisciplinary management of a primary mediastinal Ewing’s sarcoma. Minerva Chir. 2013;68:121–4.

    CAS  PubMed  Google Scholar 

  266. Zhang WD, Zhao LL, Huang XB, et al. Computed tomography imaging of anterior and middle mediastinal Ewing sarcoma/primitive neuroectodermal tumors. J Thorac Imaging. 2010;25:168–72.

    Article  PubMed  Google Scholar 

  267. Schweigert M, Meyer C, Wolf F, et al. Peripheral primitive neuroectodermal tumor of the thymus. Interact Cardiovasc Thorac Surg. 2011;12:303–5.

    Article  PubMed  Google Scholar 

  268. Koizumi K, Haraguchi S, Mikami I, et al. Video-assisted thoracic surgery for Ewing’s sarcoma of the mediastinum in a 3-year-old girl. Ann Thorac Cardiovasc Surg. 2005;11:117–20.

    PubMed  Google Scholar 

  269. El Weshi A, Allam A, Ajarim D, et al. Extraskeletal Ewing’s sarcoma family of tumours in adults: analysis of 57 patients from a single institution. Clin Oncol (R Coll Radiol). 2010;22:374–81.

    Article  Google Scholar 

  270. Javery O, Krajewski K, O’Regan K, et al. A to Z of extraskeletal Ewing sarcoma family of tumors in adults: imaging features of primary disease, metastatic patterns, and treatment responses. AJR Am J Roentgenol. 2011;197:W1015–22.

    Article  PubMed  Google Scholar 

  271. Folpe AL, Goldblum JR, Rubin BP, et al. Morphologic and immunophenotypic diversity in Ewing family tumors: a study of 66 genetically confirmed cases. Am J Surg Pathol. 2005;29:1025–33.

    Article  PubMed  Google Scholar 

  272. Kleinman GM, Young RH, Scully RE. Ependymoma of the ovary: report of three cases. Hum Pathol. 1984;15:632–8.

    Article  CAS  PubMed  Google Scholar 

  273. Bell DA, Woodruff JM, Scully RE. Ependymoma of the broad ligament. A report of two cases. Am J Surg Pathol. 1984;8:203–9.

    Article  CAS  PubMed  Google Scholar 

  274. Bale PM. Ependymal rests and subcutaneous sacrococcygeal ependymoma. Pathology. 1980;12:237–43.

    Article  CAS  PubMed  Google Scholar 

  275. Maeda S, Takahashi S, Koike K, et al. Primary ependymoma in the posterior mediastinum. Ann Thorac Cardiovasc Surg. 2011;17:494–7.

    Article  PubMed  Google Scholar 

  276. Wilson RW, Moran CA. Primary ependymoma of the mediastinum: a clinicopathologic study of three cases. Ann Diagn Pathol. 1998;2:293–300.

    Article  CAS  PubMed  Google Scholar 

  277. Nobles E, Lee R, Kircher T. Mediastinal ependymoma. Hum Pathol. 1991;22:94–6.

    Article  CAS  PubMed  Google Scholar 

  278. Estrozi B, Queiroga E, Bacchi CE, et al. Myxopapillary ependymoma of the posterior mediastinum. Ann Diagn Pathol. 2006;10:283–7.

    Article  PubMed  Google Scholar 

  279. Doglioni C, Bontempini L, Iuzzolino P, et al. Ependymoma of the mediastinum. Arch Pathol Lab Med. 1988;112:194–6.

    CAS  PubMed  Google Scholar 

  280. Neumann DP, Scholl RJ, Kellet HM, et al. Magnetic resonance imaging of a mediastinal ependymoma. Conn Med. 1998;62:527–30.

    CAS  PubMed  Google Scholar 

  281. Mori T, Nomori H, Yoshioka M, et al. A case of primary mediastinal ependymoma. Ann Thorac Cardiovasc Surg. 2009;15:332–5.

    PubMed  Google Scholar 

  282. Anderson MS. Myxopapillary ependymomas presenting in the soft tissue over the sacrococcygeal region. Cancer. 1966;19:585–90.

    Article  CAS  PubMed  Google Scholar 

  283. Helwig EB, Stern JB. Subcutaneous sacrococcygeal myxopapillary ependymoma. A clinicopathologic study of 32 cases. Am J Clin Pathol. 1984;81:156–61.

    Article  CAS  PubMed  Google Scholar 

  284. Grody WW, Nieberg RK, Bhuta S. Ependymoma-like tumor of the mesovarium. Arch Pathol Lab Med. 1985;109:291–3.

    CAS  PubMed  Google Scholar 

  285. Moran CA, Suster S. Mediastinal hemangiomas: a study of 18 cases with emphasis on the spectrum of morphological features. Hum Pathol. 1995;26:416–21.

    Article  CAS  PubMed  Google Scholar 

  286. Chan AP, Wong RH, Wan IY, et al. Video-assisted thoracic surgery excision of mediastinal hemangioma. Asian Cardiovasc Thorac Ann. 2009;17:522–4.

    Article  PubMed  Google Scholar 

  287. Yoshino N, Okada D, Ujiie H, et al. Venous hemangioma of the posterior mediastinum. Ann Thorac Cardiovasc Surg. 2012;18:247–50.

    Article  PubMed  Google Scholar 

  288. Tan C, Alphonso N, Anderson D, et al. Mediastinal haemangiomas in children. Eur J Cardiothorac Surg. 2003;23:1065–7.

    Article  PubMed  Google Scholar 

  289. Hirai K, Takeuchi S, Bessho R, et al. Venous hemangioma of the anterior mediastinum. J Nippon Med Sch. 2010;77:115–8.

    Article  PubMed  Google Scholar 

  290. Yun T, Suzuki H, Tagawa T, et al. Cavernous hemangioma of the posterior mediastinum with bony invasion. Gen Thorac Cardiovasc Surg. 2016;64:43–6.

    Article  PubMed  Google Scholar 

  291. McAdams HP, Rosado-de-Christenson ML, Moran CA. Mediastinal hemangioma: radiographic and CT features in 14 patients. Radiology. 1994;193:399–402.

    Article  CAS  PubMed  Google Scholar 

  292. Li SM, Hsu HH, Lee SC, et al. Mediastinal hemangioma presenting with a characteristic feature on dynamic computed tomography images. J Thorac Dis. 2017;9:E412–5.

    Article  PubMed  PubMed Central  Google Scholar 

  293. Nosher JL, Murillo PG, Liszewski M, et al. Vascular anomalies: a pictorial review of nomenclature, diagnosis and treatment. World J Radiol. 2014;6:677–92.

    Article  PubMed  PubMed Central  Google Scholar 

  294. Shenoy SS, Barua NR, Patel AR, et al. Mediastinal lymphangioma. J Surg Oncol. 1978;10:523–8.

    Article  CAS  PubMed  Google Scholar 

  295. Brown LR, Reiman HM, Rosenow EC 3rd, et al. Intrathoracic lymphangioma. Mayo Clin Proc. 1986;61:882–92.

    Article  CAS  PubMed  Google Scholar 

  296. Carr RF, Ochs RH, Ritter DA, et al. Fetal cystic hygroma and Turner’s syndrome. Am J Dis Child. 1986;140:580–3.

    CAS  PubMed  Google Scholar 

  297. Fisher I, Orkin M. Acquired lymphangioma (lymphangiectasis). Report of a case. Arch Dermatol. 1970;101:230–4.

    Article  CAS  PubMed  Google Scholar 

  298. Licci S, Puma F, Sbaraglia M, et al. Primary intrathymic lymphangioma. Am J Clin Pathol. 2014;142:683–8.

    Article  PubMed  Google Scholar 

  299. Oshikiri T, Morikawa T, Jinushi E, et al. Five cases of the lymphangioma of the mediastinum in adult. Ann Thorac Cardiovasc Surg. 2001;7:103–5.

    CAS  PubMed  Google Scholar 

  300. Charruau L, Parrens M, Jougon J, et al. Mediastinal lymphangioma in adults: CT and MR imaging features. Eur Radiol. 2000;10:1310–4.

    Article  CAS  PubMed  Google Scholar 

  301. Pachter MR, Lattes R. Mesenchymal tumors of the mediastinum. III. Tumors of lymph vascular origin. Cancer. 1963;16:108–17.

    Article  CAS  PubMed  Google Scholar 

  302. Weiss SW, Goldblum JR. Tumors of lymph vessels. In: Weiss SW, Goldblum JR, editors. Enzinger and Weiss’s soft tissue tumors. Philadelphia, PA: Mosby; 2001.

    Google Scholar 

  303. Faul JL, Berry GJ, Colby TV, et al. Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis, and lymphatic dysplasia syndrome. Am J Respir Crit Care Med. 2000;161:1037–46.

    Article  CAS  PubMed  Google Scholar 

  304. Kalof AN, Cooper K. D2-40 immunohistochemistry–so far! Adv Anat Pathol. 2009;16:62–4.

    Article  CAS  PubMed  Google Scholar 

  305. Folpe AL, Veikkola T, Valtola R, et al. Vascular endothelial growth factor receptor-3 (VEGFR-3): a marker of vascular tumors with presumed lymphatic differentiation, including Kaposi’s sarcoma, kaposiform and Dabska-type hemangioendotheliomas, and a subset of angiosarcomas. Mod Pathol. 2000;13:180–5.

    Article  CAS  PubMed  Google Scholar 

  306. Luks VL, Kamitaki N, Vivero MP, et al. Lymphatic and other vascular malformative/overgrowth disorders are caused by somatic mutations in PIK3CA. J Pediatr. 2015;166:1048–54.e1–5.

    Article  CAS  Google Scholar 

  307. Schiefer TK, Parker WL, Anakwenze OA, et al. Extradigital glomus tumors: a 20-year experience. Mayo Clin Proc. 2006;81:1337–44.

    Article  PubMed  Google Scholar 

  308. Mravic M, LaChaud G, Nguyen A, et al. Clinical and histopathological diagnosis of glomus tumor: an institutional experience of 138 cases. Int J Surg Pathol. 2015;23:181–8.

    Article  PubMed  PubMed Central  Google Scholar 

  309. Shugart RR, Soule EH, Johnson EW Jr. Glomus tumor. Surg Gynecol Obstet. 1963;117:334–40.

    CAS  PubMed  Google Scholar 

  310. Lee TJ, Reddy GP, Leung JW, et al. Mediastinal glomangioma: CT and octreotide scintigraphy appearance, and review of the literature. J Thorac Imaging. 2008;23:289–91.

    Article  PubMed  Google Scholar 

  311. Kanakis M, Rapti N, Chorti M, et al. Asymptomatic glomus tumor of the mediastinum. Case Rep Surg. 2015;2015:631625.

    PubMed  PubMed Central  Google Scholar 

  312. Hirose T, Hasegawa T, Seki K, et al. Atypical glomus tumor in the mediastinum: a case report with immunohistochemical and ultrastructural studies. Ultrastruct Pathol. 1996;20:451–6.

    Article  CAS  PubMed  Google Scholar 

  313. Brindley GV Jr. Glomus tumor of the mediastinum. J Thorac Surg. 1949;18:417–20.

    Article  PubMed  Google Scholar 

  314. Choi YJ, Yang KH, Gang SJ, et al. Malignant glomus tumor originating in the superior mediastinum–an immunohistochemical and ultrastructural study. J Korean Med Sci. 1991;6:157–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  315. Gaertner EM, Steinberg DM, Huber M, et al. Pulmonary and mediastinal glomus tumors–report of five cases including a pulmonary glomangiosarcoma: a clinicopathologic study with literature review. Am J Surg Pathol. 2000;24:1105–14.

    Article  CAS  PubMed  Google Scholar 

  316. Rychlik IJ, O’Donnell ME, Davey P, et al. Glomus tumor of the mediastinum. Asian Cardiovasc Thorac Ann. 2014;22:95–7.

    Article  PubMed  Google Scholar 

  317. Jang SH, Cho HD, Lee JH, et al. Mediastinal glomus tumor: a case report and literature review. J Pathol Transl Med. 2015;49:520–4.

    Article  PubMed  PubMed Central  Google Scholar 

  318. Weissferdt A, Kalhor N, Moran CA. Intrathoracic glomus tumors and glomangiosarcomas: a clinicopathological and immunohistochemical study of 14 cases with emphasis on anatomic distribution. Virchows Arch. 2016;469:541–6.

    Article  CAS  PubMed  Google Scholar 

  319. Koss MN, Hochholzer L, Moran CA. Primary pulmonary glomus tumor: a clinicopathologic and immunohistochemical study of two cases. Mod Pathol. 1998;11:253–8.

    CAS  PubMed  Google Scholar 

  320. Dong LL, Chen EG, Sheikh IS, et al. Malignant glomus tumor of the lung with multiorgan metastases: case report and literature review. Onco Targets Ther. 2015;8:1909–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  321. Folpe AL, Fanburg-Smith JC, Miettinen M, et al. Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors. Am J Surg Pathol. 2001;25:1–12.

    Article  CAS  PubMed  Google Scholar 

  322. Bhagavan BS, Dorfman HD, Murthy MS, et al. Intravascular bronchiolo-alveolar tumor (IVBAT): a low-grade sclerosing epithelioid angiosarcoma of lung. Am J Surg Pathol. 1982;6:41–52.

    Article  CAS  PubMed  Google Scholar 

  323. Dietze O, Davies SE, Williams R, et al. Malignant epithelioid haemangioendothelioma of the liver: a clinicopathological and histochemical study of 12 cases. Histopathology. 1989;15:225–37.

    Article  CAS  PubMed  Google Scholar 

  324. Tsuneyoshi M, Dorfman HD, Bauer TW. Epithelioid hemangioendothelioma of bone. A clinicopathologic, ultrastructural, and immunohistochemical study. Am J Surg Pathol. 1986;10:754–64.

    Article  CAS  PubMed  Google Scholar 

  325. Weiss SW, Ishak KG, Dail DH, et al. Epithelioid hemangioendothelioma and related lesions. Semin Diagn Pathol. 1986;3:259–87.

    CAS  PubMed  Google Scholar 

  326. Suster S, Moran CA, Koss MN. Epithelioid hemangioendothelioma of the anterior mediastinum. Clinicopathologic, immunohistochemical, and ultrastructural analysis of 12 cases. Am J Surg Pathol. 1994;18:871–81.

    Article  CAS  PubMed  Google Scholar 

  327. Ferretti GR, Chiles C, Woodruff RD, et al. Epithelioid hemangioendothelioma of the superior vena cava: computed tomography demonstration and review of the literature. J Thorac Imaging. 1998;13:45–8.

    Article  CAS  PubMed  Google Scholar 

  328. Deyrup AT, Tighiouart M, Montag AG, et al. Epithelioid hemangioendothelioma of soft tissue: a proposal for risk stratification based on 49 cases. Am J Surg Pathol. 2008;32:924–7.

    Article  PubMed  Google Scholar 

  329. Gill R, O’Donnell RJ, Horvai A. Utility of immunohistochemistry for endothelial markers in distinguishing epithelioid hemangioendothelioma from carcinoma metastatic to bone. Arch Pathol Lab Med. 2009;133:967–72.

    Article  CAS  PubMed  Google Scholar 

  330. Miettinen M, Wang ZF, Paetau A, et al. ERG transcription factor as an immunohistochemical marker for vascular endothelial tumors and prostatic carcinoma. Am J Surg Pathol. 2011;35:432–41.

    Article  PubMed  PubMed Central  Google Scholar 

  331. Errani C, Zhang L, Sung YS, et al. A novel WWTR1-CAMTA1 gene fusion is a consistent abnormality in epithelioid hemangioendothelioma of different anatomic sites. Genes Chromosomes Cancer. 2011;50:644–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  332. Tanas MR, Sboner A, Oliveira AM, et al. Identification of a disease-defining gene fusion in epithelioid hemangioendothelioma. Sci Transl Med. 2011;3:98ra82.

    Article  PubMed  CAS  Google Scholar 

  333. Gibbs AR, Johnson NF, Giddings JC, et al. Primary angiosarcoma of the mediastinum: light and electron microscopic demonstration of Factor VIII-related antigen in neoplastic cells. Hum Pathol. 1984;15:687–91.

    Article  CAS  PubMed  Google Scholar 

  334. Lucas DR. Angiosarcoma, radiation-associated angiosarcoma, and atypical vascular lesion. Arch Pathol Lab Med. 2009;133:1804–9.

    Article  PubMed  Google Scholar 

  335. Weissferdt A, Kalhor N, Suster S, et al. Primary angiosarcomas of the anterior mediastinum: a clinicopathologic and immunohistochemical study of 9 cases. Hum Pathol. 2010;41:1711–7.

    Article  CAS  PubMed  Google Scholar 

  336. Kardamakis D, Bouboulis N, Ravazoula P, et al. Primary hemangiosarcoma of the mediastinum. Lung Cancer. 1996;16:81–6.

    Article  CAS  PubMed  Google Scholar 

  337. Fong Y, Coit DG, Woodruff JM, et al. Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg. 1993;217:72–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  338. Meis-Kindblom JM, Kindblom LG. Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol. 1998;22:683–97.

    Article  CAS  PubMed  Google Scholar 

  339. Fayette J, Martin E, Piperno-Neumann S, et al. Angiosarcomas, a heterogeneous group of sarcomas with specific behavior depending on primary site: a retrospective study of 161 cases. Ann Oncol. 2007;18:2030–6.

    Article  CAS  PubMed  Google Scholar 

  340. Christopherson WM, Foote FW Jr, Stewart FW. Alveolar soft-part sarcomas; structurally characteristic tumors of uncertain histogenesis. Cancer. 1952;5:100–11.

    Article  CAS  PubMed  Google Scholar 

  341. Portera CA Jr, Ho V, Patel SR, et al. Alveolar soft part sarcoma: clinical course and patterns of metastasis in 70 patients treated at a single institution. Cancer. 2001;91:585–91.

    Article  PubMed  Google Scholar 

  342. Lieberman PH, Brennan MF, Kimmel M, et al. Alveolar soft-part sarcoma. A clinico-pathologic study of half a century. Cancer. 1989;63:1–13.

    Article  CAS  PubMed  Google Scholar 

  343. Flieder DB, Moran CA, Suster S. Primary alveolar soft-part sarcoma of the mediastinum: a clinicopathological and immunohistochemical study of two cases. Histopathology. 1997;31:469–73.

    Article  CAS  PubMed  Google Scholar 

  344. Folpe AL, Deyrup AT. Alveolar soft-part sarcoma: a review and update. J Clin Pathol. 2006;59:1127–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  345. Khanna P, Paidas CN, Gilbert-Barness E. Alveolar soft part sarcoma: clinical, histopathological, molecular, and ultrastructural aspects. Fetal Pediatr Pathol. 2008;27:31–40.

    Article  CAS  PubMed  Google Scholar 

  346. Karnauchow PN, Magner D. The histogenesis of alveolar soft part sarcoma. J Pathol Bacteriol. 1963;86:169–77.

    Article  CAS  PubMed  Google Scholar 

  347. Kameda Y, Nishii T, Tsuboi M, et al. Alveolar soft-part sarcoma of the mediastinum: a case report. SAGE Open Med Case Rep. 2017;5:2050313X17695473.

    PubMed  PubMed Central  Google Scholar 

  348. Stacchiotti S, Negri T, Zaffaroni N, et al. Sunitinib in advanced alveolar soft part sarcoma: evidence of a direct antitumor effect. Ann Oncol. 2011;22:1682–90.

    Article  CAS  PubMed  Google Scholar 

  349. Argani P, Lal P, Hutchinson B, et al. Aberrant nuclear immunoreactivity for TFE3 in neoplasms with TFE3 gene fusions: a sensitive and specific immunohistochemical assay. Am J Surg Pathol. 2003;27:750–61.

    Article  PubMed  Google Scholar 

  350. Ribbert H, Steiner H. Über die Ecchondrosis Physalifora Sphenooccipitalis. Zentralbl Allg Pathol Anat. 1894;5:457–61.

    Google Scholar 

  351. Dahlin DC, MacCarty CS. Chordoma. Cancer. 1952;5:1170–8.

    Article  CAS  PubMed  Google Scholar 

  352. Heaton JM, Turner DR. Reflections on notochordal differentiation arising from a study of chordomas. Histopathology. 1985;9:543–50.

    Article  CAS  PubMed  Google Scholar 

  353. Mirra JM. Bone tumors. Philadelphia: Lea and Febiger; 1989. p. 648–74.

    Google Scholar 

  354. Suster S, Moran CA. Chordomas of the mediastinum: clinicopathologic, immunohistochemical, and ultrastructural study of six cases presenting as posterior mediastinal masses. Hum Pathol. 1995;26:1354–62.

    Article  CAS  PubMed  Google Scholar 

  355. Matsubayashi J, Sato E, Nomura M, et al. A case of paravertebral mediastinal chordoma without bone destruction. Skelet Radiol. 2012;41:1641–4.

    Article  Google Scholar 

  356. Huang SM, Chen CC, Chiu PC, et al. Unusual presentation of posterior mediastinal chordoma in a 2-year-old boy. J Pediatr Hematol Oncol. 2003;25:743–6.

    Article  PubMed  Google Scholar 

  357. Soudack M, Guralnik L, Ben-Nun A, et al. Imaging features of posterior mediastinal chordoma in a child. Pediatr Radiol. 2007;37:492–7.

    Article  PubMed  Google Scholar 

  358. Selvaraj A, Wood AJ. Superior mediastinal chordoma presenting as a bilobed paravertebral mass. Eur J Cardiothorac Surg. 2003;23:248–50.

    Article  PubMed  Google Scholar 

  359. Rahman AM, Farahat IG, Ali WA, et al. Giant mediastinal chordoma. Ann Thorac Surg. 2002;73:1952–4.

    Article  CAS  PubMed  Google Scholar 

  360. Clemons RL, Blank RH, Hutcheson JB, et al. Chordoma presenting as a posterior mediastinal mass. A choristoma. J Thorac Cardiovasc Surg. 1972;63:922–4.

    Article  CAS  PubMed  Google Scholar 

  361. Castellano GC, Johnston HW. Intrathoracic chordoma presenting as a posterior mediastinal tumor. South Med J. 1975;68:109–12.

    Article  CAS  PubMed  Google Scholar 

  362. Ahrendt MN, Wesselhoeft CW. Chordoma presenting as a posterior mediastinal mass in a pediatric patient. J Pediatr Surg. 1992;27:1515–8.

    Article  CAS  PubMed  Google Scholar 

  363. Roeyen G, Van Schil P, Somville J, et al. Chordoma of the mediastinum. Eur J Surg Oncol. 1999;25:224–5.

    CAS  PubMed  Google Scholar 

  364. Tai PT, Craighead P, Liem SK, et al. Management issues in chordoma: a case series. Clin Oncol (R Coll Radiol). 2000;12:80–6.

    CAS  Google Scholar 

  365. Rich TA, Schiller A, Suit HD, et al. Clinical and pathologic review of 48 cases of chordoma. Cancer. 1985;56:182–7.

    Article  CAS  PubMed  Google Scholar 

  366. Tirabosco R, Mangham DC, Rosenberg AE, et al. Brachyury expression in extra-axial skeletal and soft tissue chordomas: a marker that distinguishes chordoma from mixed tumor/myoepithelioma/parachordoma in soft tissue. Am J Surg Pathol. 2008;32:572–80.

    Article  PubMed  Google Scholar 

  367. Sangoi AR, Dulai MS, Beck AH, et al. Distinguishing chordoid meningiomas from their histologic mimics: an immunohistochemical evaluation. Am J Surg Pathol. 2009;33:669–81.

    Article  PubMed  PubMed Central  Google Scholar 

  368. Yamaguchi T, Suzuki S, Ishiiwa H, et al. Benign notochordal cell tumors: a comparative histological study of benign notochordal cell tumors, classic chordomas, and notochordal vestiges of fetal intervertebral discs. Am J Surg Pathol. 2004;28:756–61.

    Article  PubMed  Google Scholar 

  369. Enzinger FM. Angiomatoid malignant fibrous histiocytoma: a distinct fibrohistiocytic tumor of children and young adults simulating a vascular neoplasm. Cancer. 1979;44:2147–57.

    Article  CAS  PubMed  Google Scholar 

  370. Costa MJ, Weiss SW. Angiomatoid malignant fibrous histiocytoma. A follow-up study of 108 cases with evaluation of possible histologic predictors of outcome. Am J Surg Pathol. 1990;14:1126–32.

    Article  CAS  PubMed  Google Scholar 

  371. Asakura S, Tezuka N, Inoue S, et al. Angiomatoid fibrous histiocytoma in mediastinum. Ann Thorac Surg. 2001;72:283–5.

    Article  CAS  PubMed  Google Scholar 

  372. Chen G, Folpe AL, Colby TV, et al. Angiomatoid fibrous histiocytoma: unusual sites and unusual morphology. Mod Pathol. 2011;24:1560–70.

    Article  CAS  PubMed  Google Scholar 

  373. Davies KA, Cope AP, Schofield JB, et al. A rare mediastinal tumour presenting with systemic effects due to IL-6 and tumour necrosis factor (TNF) production. Clin Exp Immunol. 1995;99:117–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  374. Fletcher CD. Angiomatoid “malignant fibrous histiocytoma”: an immunohistochemical study indicative of myoid differentiation. Hum Pathol. 1991;22:563–8.

    Article  CAS  PubMed  Google Scholar 

  375. Fanburg-Smith JC, Miettinen M. Angiomatoid “malignant” fibrous histiocytoma: a clinicopathologic study of 158 cases and further exploration of the myoid phenotype. Hum Pathol. 1999;30:1336–43.

    Article  CAS  PubMed  Google Scholar 

  376. Tanas MR, Rubin BP, Montgomery EA, et al. Utility of FISH in the diagnosis of angiomatoid fibrous histiocytoma: a series of 18 cases. Mod Pathol. 2010;23:93–7.

    Article  CAS  PubMed  Google Scholar 

  377. Hasegawa T, Seki K, Ono K, et al. Angiomatoid (malignant) fibrous histiocytoma: a peculiar low-grade tumor showing immunophenotypic heterogeneity and ultrastructural variations. Pathol Int. 2000;50:731–8.

    Article  CAS  PubMed  Google Scholar 

  378. Dunham C, Hussong J, Seiff M, et al. Primary intracerebral angiomatoid fibrous histiocytoma: report of a case with a t(12;22)(q13;q12) causing type 1 fusion of the EWS and ATF-1 genes. Am J Surg Pathol. 2008r;32:478–84.

    Article  PubMed  Google Scholar 

  379. Shao L, Singh V, Cooley L. Angiomatoid fibrous histiocytoma with t(2;22)(q33;q12.2) and EWSR1 gene rearrangement. Pediatr Dev Pathol. 2009;12:143–6.

    Article  PubMed  Google Scholar 

  380. Antonescu CR, Dal Cin P, Nafa K, et al. EWSR1-CREB1 is the predominant gene fusion in angiomatoid fibrous histiocytoma. Genes Chromosomes Cancer. 2007;46:1051–60.

    Article  CAS  PubMed  Google Scholar 

  381. Waters BL, Panagopoulos I, Allen EF. Genetic characterization of angiomatoid fibrous histiocytoma identifies fusion of the FUS and ATF-1 genes induced by a chromosomal translocation involving bands 12q13 and 16p11. Cancer Genet Cytogenet. 2000;121:109–16.

    Article  CAS  PubMed  Google Scholar 

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Weissferdt, A. (2020). Mesenchymal Tumors of the Mediastinum. In: Diagnostic Thoracic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-36438-0_31

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