Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2019; 7(17): 2637-2643
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2637
Calcifying fibrous tumor of the mediastinum: A case report
Dian-Jun Qi, Qing-Fu Zhang
Dian-Jun Qi, Department of General Practice, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Qing-Fu Zhang, Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Qi DJ and Zhang QF conceived the study; Qi DJ searched the published articles, analyzed the data, and wrote the manuscript; Zhang QF reviewed and confirmed the final version of the manuscript and provided funding.
Supported by Natural Science Foundation of Liaoning Province in China, No. 81572621 and No. 2019-MS-370.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qing-Fu Zhang, MD, Associate Professor, Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China. qfzhang@cmu.edu.cn
Telephone: +86-24-83282946 Fax: +86-24-83282946
Received: April 19, 2019
Peer-review started: April 22, 2019
First decision: June 12, 2019
Revised: June 27, 2019
Accepted: July 20, 2019
Article in press: July 20,2019
Published online: September 6, 2019
Abstract
BACKGROUND

Calcifying fibrous tumor (CFT) is a rare benign mesenchymal tumor that often occurs in deep soft tissue of children and young adults. CFT rarely occurs in the mediastinum.

CASE SUMMARY

In this paper, we describe a 31-year-old male patient with CFT in the mediastinum. The patient did not have any symptoms, and the posterior mediastinal lesion was unintentionally found during routine re-examination of thyroid cancer. The tumor had no adhesion to the surrounding tissue and was successfully and completely removed. Pathology showed a large amount of collagen-rich fibrous connective tissue. There was scattered dystrophic calcification and gravel in the fibrous tissue and a small amount of lymphocyte and plasma cell infiltration and lymphoid follicle formation in the interstitial fluid. In addition, findings showed 20 IgG4+ plasma cells per high-powered field of the diseased tissue, an IgG4+/IgG ratio of about 20%, and normal serum IgG4 levels. The final diagnosis was CFT of the mediastinum (CFTM). No evidence of tumor recurrence was observed by computed tomography at 3 mo after surgery.

CONCLUSION

IgG4+ plasma cell enlargement may occur in CFTM, but clinical manifestations and serological tests suggest that it is not IgG4-related disease. We speculate that it may be an independent tumor subtype.

Keywords: Calcifying fibrous tumor, Mediastinum, IgG4-related diseases, Case report

Core tip: Calcifying fibrous tumor of the mediastinum (CFTM) is a rare benign mesenchymal tumor that often occurs in children and young adults. Calcifying fibrous tumor rarely occurs in the mediastinum. Histological examination is the most important basis for diagnosis. Surgical resection is currently the primary means of treatment. There are no reports of recurrence of CFTM.