ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Mediastinal epithelioid angiosarcoma arising in schwannoma: The first case in the literature
Ş. Mustafa Demiröz1, Göktürk Fındık1, Koray Aydoğdu1, Barış Hekimoğlu1, Funda İncekara1, Funda Demirağ2, Sadi Kaya1
1Department of Thoracic Surgery, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
2Department of Pathology, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2018.14795
Angiosarcoma arising in a long-standing schwannoma is extremely rare and only a few cases were reported in the English literature. Besides tumors arising from vagus, sciatic or adrenal nerves, tumors growing on neck, foot or kidney were also described. To the best of our knowledge, in this article, we report the first mediastinal case occurring in longstanding schwannoma in a 53-year-old female patient. The patient was admitted to our clinic with severe dyspnea and palpitation. Her medical history showed a progressive right-sided paramediastinal mass which was first diagnosed in 2002. Three transthoracic needle biopsies performed in 2002, 2015 and 2016 were all non-diagnostic. An operation was suggested since 2002, but the patient has not accepted. Thorax computed tomography and magnetic resonance imaging revealed a huge mediastinal mass nearly fulfilling the right hemithorax. A diagnosis of “malign spindle cell tumor” was established with the last transthoracic biopsy and total surgical resection via posterolateral throcatomy was performed. Microscopically, tumor was composed of two components: a benign schwannoma and an epithelioid angiosarcoma. Endothelial and neural cell differentiations were confirmed immunohistochemically.
Keywords : Angiosarcoma; chemotherapy; mediastinum; schwannoma; thoracotomy.
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