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• W2897841655 abstract "Masson's tumor or intravascular papillary endothelial hyperplasia (IPEH) is a rare non-malignant pseudotumoral disease, characterized by an exuberant endothelial proliferation usually arising as a reactive process within a normal blood vessel. The pathogenesis of intravascular papillary endothelial hyperplasia is still unclear, but it seems that the exuberant tissue derives from an autocrine stimulation of the endothelial cells due to the secretion of basic Fibroblast Growth Factor (bFGF). There are three types of papillary endothelial hyperplasia: primary or intravascular form, secondary or mixed form and tertiary or extravascular (rarer) form. Mediastinal localization is exceptional. We report a rare case of antero-superior mediastinal Masson's tumor mimicking a thymoma, successfully treated with surgery. A 48-year old man presented to our institution with computerized tomography (CT) evidence of a 4 x 3 cm antero-superior mediastinal mass, extending up to the right thyroid lobe, resembling a thymoma. Total body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT revealed a SUV max of 3.5. Despite complaining of a myastheniform syndrome (asthenia and slight palpebral ptosis) laboratory (anti-MUsk and anti-AChR antibodies) and instrumental evaluation (electromyography) were found to be normal. The patient had previously undergone resection of a right supraclavicular Masson's tumor and of a sublingual angioma. After cardio-respiratory function evaluation, through a sternotomy, the patient underwent thymectomy and challenging resection of a hypervascularized mediastinal lesion adjacent to the right upper horn of the thymus, but apparently independent from it, and tenaciously adherent to the right innominate vein. Postoperative course was uneventful. Histopathology revealed a normal adipose thymic involution and a Masson's tumor or intravascular papillary endothelial hyperplasia with mediastinal localization. The patient underwent hemocoagulative and genetic tests, as Masson's tumor may be associated with thrombophilia and genetic syndromes. Masson's tumor can clinically and radiologically mimic various benign and malignant mediastinal lesions, such as thymomas. The definitive diagnosis can be obtained only with the histological examination, demonstrating the presence of endothelial papillae, with a thin fibrous stroma, protruding into the vessel lumen. To the best of our knowledge, this is the first reported case of surgical treatment of a mediastinal Masson's tumor. However, surgical resection may be technically difficult due to the intrinsic hypervascularized nature of these pseudotumoral lesions." @default.
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• W2897841655 date "2018-10-01" @default.
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• W2897841655 title "P3.CR-27 Surgical Treatment of a Rare Case of Mediastinal Masson's Tumor Mimicking a Thymoma" @default.
• W2897841655 doi "https://doi.org/10.1016/j.jtho.2018.08.2006" @default.
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