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International Journal of Morphology

On-line version ISSN 0717-9502

Abstract

DIAZ-PEREZ, Julio Alexander  and  FERREIRA BOHORQUEZ, Edgar Julian. Mediastinal Malignant Peripheral Nerve Sheath Tumor in a Neurofibromatosis Type 1 Patient. Int. J. Morphol. [online]. 2011, vol.29, n.1, pp.133-139. ISSN 0717-9502.  http://dx.doi.org/10.4067/S0717-95022011000100023.

The malignant peripheral nerve sheath tumor (MPNST) is a malignant neoplasm originated in the Schwan cells of the periferic nerves sheath. We describe a case of a man with Neurofibroatosis Type 1 (NF1), who developed a low grade MPNST, and subsequent to a discussion of this disease. 28-year-old Man with pleuritic pain in the left hemithorax, dyspnea and weight loss, with a previous diagnosis of NF1, from the age of 15 and a family history of NF1. At chest examination the patient had an intense thoracic kyphosis, with a decline in the ventilation of the inferior two thirds of the left hemithorax, where a dull sound to percusión was also found. The chest X rays showed a large radiopaque and well delimited mass in the posterior mediastinum, that pushed the cardiovascular structures to the anterior region, which was also documented by chest computed tomography (CT). In view of the above, a puncture biopsy was performed with thick needle guided by CT, from where a malignant mesenhymal neoplasm was identified. It was decided to perform the resection of the tumor of the left posterior mediastinum, by left posterior lateral thoracotomy, in which a large mass of 8x9x9 cm was obtanied, with irregular external surface, brown-violet, and firm. The histopathological and inmunophenotypic study concluded the diagnosis of MPNST in the posterior mediastinum grade 1. Following surgery the patient was asymptomatic. We present a case of MPNST which originated in a patient with NF1, who would usually have a worse prognosis. A brief review of the more relevant aspects of this disease was also reported, some of which have shown important progress in recent years.

Keywords : Malignant peripheral nerve sheath tumor; Nerve Sheath Neoplasms; Neurofibromatosis 1; Mediastinal neoplasms.

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