Abstract
An 80-year-old woman was found to have an abnormal shadow on a routine chest radiograph. Subsequent chest CT demonstrated a round-shaped, 57×46-mm mass in the superior portion of the mediastinum and middle mediastinum, surrounded by the great vessels and trachea. FDG positron emission tomography (FDG-PET) revealed high-level FDG uptake by the tumor; malignant mediastinal tumor was suspected. She was referred to our hospital for diagnosis and treatment. Surgery using a limited upper sternotomy approach revealed a sessile tumor originating from the mediastinal soft tissue around the right brachiocephalic artery. We were unable to perform a combined resection of the brachiocephalic artery; thus, tumor resection was incomplete. Histopathologically, the tumor was diagnosed as benign SFT. Immunohistochemical examination revealed negativity for CD34, loss of bcl-2 expression, a high MIB-1 index, and positive p53 staining, and also suggested signs of malignancy. The patient elected not to receive any further surgery, and was simply followed up. The residual tumor had re-progressed 6 months postoperatively, and was then treated with conventional radiotherapy (60 Gy). The patient remains alive with disease 2 years postoperatively. SFT originating from the mediastinum is extremely rare, but may be more aggressive and malignant than SFT of the pleura. We report this case and provide a bibliographic review on the biological behavior and treatment of SFT originating from the mediastinum.
