Abstract
Primary mediastinal neuroendocrine neoplasms, as they are referred to in this chapter, encompass several tumors that do not necessarily share the same histogenesis, biologic behavior, or treatment modalities. In addition, some of these tumors may in turn occur as ectopically placed tissues that may be deposited in the mediastinal compartment. In some of these cases, the embryologic development may be the clue to their occurrence. Nevertheless, this group of tumors ranges from the benign tumors to the overtly high-grade malignancy. Basically, the group of tumors that more often present as mediastinal tumors are neuroendocrine carcinomas (well-differentiated neuroendocrine carcinoma (carcinoid tumor), moderately differentiated neuroendocrine carcinoma (atypical carcinoid), poorly differentiated neuroendocrine carcinoma (small cell carcinoma and large cell neuroendocrine carcinoma), paragangliomas, parathyroid tumors (parathyroid adenoma, parathyroid carcinoma), thyroid tumors (intrathoracic goiter, thyroid carcinoma). This chapter will be presented from the practical point of view for the practicing pathologist who may be called upon to interpret these tumors. Clinical, pathological, histopathological, immunohistochemical, radiological, gross, molecular features will be discussed, as well as differential diagnoses and staging.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Oldham HN, Sabiston DC. Primary tumors and cysts of the mediastinum. Arch Surg. 1968;96:71–5.
Wychulis AR, Payne WS, Clagett OT, Woolner LB. Surgical treatment of mediastinal tumors: a 40-year experience. J Thorac Cardiovasc Surg. 1971;62:379–92.
Blegvad S, Lippert H, Simper LB, Dybdahl H. Mediastinal tumours. Scand J Thor Cardiovasc Surg. 1990;24:39–42.
Hanagiri T, Hatooka S, Oosaki T, Nakanishi R, Mitsudomi T, Shirakusa T. Papillary carcinoma in a huge intrathoracic goiter with tracheal stenosis and invasion. Scand J Thor Cardiovasc Surg. 1993;27:165–8.
Adkins PB, Maples MD, Hainsworth JD. Primary malignant mediastinal tumors. Ann Thorac Surg. 1984;38:648–59.
Rosai J, Higa E. Mediastinal endocrine neoplasm of probable thymic origin related to carcinoid tumor. Cancer. 1972;29:1061–74.
Pachter MR, Lattes R. Uncommon mediastinal tumors. Dis Chest. 1963;43:519–28.
Wick MR, Rosai J. Neuroendocrine neoplasms of the mediastinum. Semin Diagn Pathol. 1991;8:35–51.
Wick MR. Mediastinal cysts and intrathoracic thyroid tumors. Seminar in Diagnostic Pathology. 1990;7:285–94.
Klemm KM, Moran CA. Primary neuroendocrine carcinomas of the thymus. Semin Diagn Pathol. 1999;16:32–41.
Moran CA. Primary neuroendocrine carcinomas of the mediastinum: review of current criteria for histopathologic diagnosis and classification. Semin Diagn Pathol. 2005;22:223–9.
Moran CA, Suster S. Neuroendocrine carcinomas (carcnoid, atypical carcinoid, small cell carcinoma, and large cell neuroendocrine carcinoma): current concepts. Hematol Oncol Clin North Am. 2007;21:395–407.
Rosai J, HIga E, Davie J. Mediastinal endocrine neoplasm in patients with multipke endocrine adenomatosis: a previously unrecognized association. Cancer. 1972;29:1075–83.
Manes JL, Taylor HB. Thymic carcnoid in familial multiple endocrine adenomatosis. Arch Pathol. 1973;95:252–5.
Lockich JJ, Li F. Carcinoid of the thymus with hereditary hyperparathyroidism. Ann Int Med. 1978;89:364–5.
Marchevsky AM, Dikman SH. Mediastinal carcinoid with incomplete Sipple’s syndrome. Cancer. 1979;43:2497–501.
Stewart CA, Kingston CW. Carcinoid tumour of the thymus with Cushing’s syndrome. Pathology. 1980;12:487–94.
Floros D, Dosios T, Tsourdis A, Yiatromanolakis N. Carcinoid tumor of the thymus with multiple endocrine adenomatosis. Path Res Pract. 1982;175:404–9.
Brown LR, Aughenbaugh GL, Wick MR, Baker BA, Salassa RM. Roentgenologic diagnosis of primary corticotropin-producing carcinoid tumor of the mediastinum. Radiology. 1982;142:143–8.
Thorner MO, Martin WH, Ragan GE, MacLeod RM, Feldman PS, Bruni C, et al. A case of ectopic ACTH syndrome: diagnostic difficulties caused by intermittent secretion. Acta Endcorinol. 1982;99:364–70.
Birnberg FA, Webb WR, Selch MT, Gamsu G, Goodman PC, et al. Thymic carcinoid tumors with hyperparathyroidism. Am J Radiol. 1982;139:1001–4.
Vener JD, Zuckerbraun L, Goodman D. Carcinoid tumor of the thymus associated with a parathyroid adenoma. Arch Otoloryngol. 1982;99:324–6.
Huntrakoon M, Lin F, Heitz PU, Tomita T. Thymic carcinoid tumor with Cushing’s syndrome: report of a case with electron microscopic and immunoperoxidase studies for neuron-specific enolase and corticotropin. Arch Pathol Lab Med. 1984;108:551–4.
Lieske TR, Kincaid J, Sunderrajan JV. Tjhymic carcinoid with cutaneous hyperpigmentation. Ach Int Med. 1985;145:361–3.
Gartner LA, Voorhess ML. Adrenocorticotropin hormone-producing thymic carcinoid in a teenager. Cancer. 1993;71:106–11.
Kimura N, Ishikawa T, Sasaki Y, Sasano N, Onodera K, Shimizu Y, et al. Expression of prohormone convertase, PC2, in adrenocorticotropin-producing thymic carcinoid with elevated plasma corticotropin-releasing hormone. J Clin Endocrinol Metab. 1996;81:390–5.
Baker J, Holdaway IM, Jagush M, Kerr AR, Donald RA, Pullan PT. Ectopic secretion of ACTH and met-enkephalin from a thymic carcinoid. J Endocrinol Investig. 1982;5:33–8.
Yamaji I, Iimura O, Mito T, Yoshida S, Shimamoto K, Minase T. An ectopic ACTH producing oncocytic carcinoid tumor of the thymus: report of a case. Jpn J Med. 1984;23:62–6.
Zieger MA, Swartz SE, MacGillivray DC, Linnoila I, Shakir M. Thymic carcinoid in association with MEN syndromes. Am Surg. 1992;58:430–4.
Wollensak G, Herbst EW, Beck A, Schaefer HE. Primary thymic carcinoid with Cushing’s syndrome. Virch Arch A Pathol Anat. 1992;420:191–5.
Zahner J, Borchard F, Schmitz U, Schneider W. Thymus carcinoid in multiple endocrine neoplasms type I. Dtsch Med Wochenschr. 1994;119:135–40.
Gelfand ET, Basualdo CA, Callagham JC. Carcinoid tumor of the thymus associated with recurrent pericarditis. Chest. 1981;79:350–1.
Pimstone BL, Uys CJ, Vogelpoel L. Studies in a case of Cushing’s syndrome due to an ACTH-producing thymic tumour. Am J Med. 1972;53:521–8.
Lowenthal RM, Gumpel JM, Kreel L, McLaughlin JE, Skeggs BL. Carcinoid tumour of the thymus with systemic manifestations: a radiological and pathological study. Thorax. 1974;29:553–8.
Teh BT, McArdle J, Chan SP, Menon J, Hartley L, Pullan P, et al. Clinicopathologic studies of thymic carcinoids in multiple endocrine neoplasia type 1. Medicine. 1997;76:21–9.
Wick MR, Scheithauer BW. Thymic carcinoid. A histologic, immunohistochemical, and ultrastructural study of 12 cases. Cancer. 1984;53:475–84.
Wick MR, Scott RE, Li CY, Carney JA. Carcinoid tumor of the thyus. A clinicopathologic report of seven cases with a review of the literature. Mayo Clin Proc. 1980;55:246–54.
De Montpreville VT, Macchiarini P, Dulmet E. Thymic neuroendocrine carcinoma (carcinoid): a clinicopathologic study of fourteen cases. J Thorac Cardiovasc Surg. 1996;111:134–41.
Economopoulos GC, Lewis JW, Lee MW, Silverman NA. Carcinoid tumors of the thymus. Ann Thorac Surg. 1990;50:58–61.
Wang DY, Chang DB, Kuo SH, Yang PC, Lee YC, Hsu HC, et al. Carcinoid tumours of the thymus. Thorax. 1994;49:357–60.
Cardillo G, Treggiari S, Paul MA, Carleo F, De Massimi AR, Remotti D, et al. Primary neuroendocrine tumours of the thymus: a cllinicopathologic and prognostic study of 19 patients. European J Cardio-thoracic Surgery. 2010;37:814–8.
Cardillo G, Rea F, Lucchi M, Paul MA, Margaritora S, Carleo F, et al. Primary neuroendocrine tumors of the thymus: a multicenter experience of 35 patients. Ann Thorac Surg. 2012;94:241–6.
Neary NM, Lopez-Chavez A, Abel BS, Boyce AM, Schaub N, Kwong K, et al. Neuroendocrine ACTH-producing tumor of the thymus – experience with 12 patients over 25 years. J Endocrinol Metab. 2012;97:2223–30.
Moran CA, Suster S. Neuroendocrine carcinomas (Carcinoid Tumor) of the thymus. A clinicopathologic analysis of 80 cases. Am J Clin Pathol. 2000;114:100–10.
World Health Organization (WHO) Classification of Tumours. In: Travis WD, Brambilla E, Muller-Hermelink HK, editors. Patholgy & genetics, tumours of the lung, pleura, thymus, and heart. WHO; Lyon, France. 2004. p. 188–95.
Gal AA, Kornstein MJ, Cohen C, Duarte IG, Miller JI, Mansour KA. Neuroendocrine tumors of the thymus: a clinicopathological and prognostic study. Ann Thorac Surg. 2001;72:1179–82.
Weissferdt A, Moran CA. thymic carcinoma, part 2: a clinicopathologic correlation of 33 cases with a proposed staging system. Am J Clin Pathol. 2012;138:115–21.
Weissferdt A, Moran CA. Staging of primary mediastinal tumors. Adv Anat Pathol. 2013;20(1):1–9.
Valli M, Fabris GA, Dewar A, Chikte S, Fisher C, Corrin B, et al. Atypical carcinoid tumour of the thymus: a study of 8 cases. Histopathology. 1994;24:71–375.
Rosai J, editor. WHO Histological typing of tumours of the thymus. 2nd ed; Springer-Verlag Berlin. 1999.
Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG, editors. WHO classification of tumours of the lung, pleura, thymus, and heart; Springer-Verlag Berlin. 2015. p. 234–8.
Tsuta K, Raso MG, Kalhor N, Liu DD, Wistuba II, Moran CA. Histologic features of low- and intermediate-grade neuroendocrine carcinoma (typical and atypical carcinoid tumors) of the lung. Lung Cancer. 2011;71:34–41.
Hughes JP, Ancalmo N, Leonard GL, Ochsner JL. Carcinoid tumour of the thymus gland: report of a case. Thorax. 1975;30:470–5.
Tanaka T, Tanaka S, Kimura H, Ito J. Mediastinal tumor of thymic origin and related to carcinoid tumor. Acta Path Jpn. 1974;24:413–26.
Sundstrom C, Wilander E. Thymic carcinoid: a case report. Acta Pathol Microbiol Scand Sect A. 1976;84:311–6.
Blom P, Johannessen JV. Mediastinal mass in a young male. Ultrastruct Pathol. 1983;4:391–5.
Llaverias S, Valls C, Picas E. Carcinoid tumor of the thymus. AJR. 1984;163:478.
Kogan J. Carcinoid tumor of the thymus. Postgrad Med. 1984;75:291–6.
Chalk S, Donald KJ. Carcinoid tumor of the thymus. A case report including discussion of the morphological diagnosis and the cell or origin. Virchows Arch A Pathol Anat Histol. 1977;377:91–6.
Viebahn R, Hiddemann W, Klinke F, Bassewitz DB. Thymus carcinoid. Pathol Res Pract. 1985;180:445–8.
Salyer WR, Salyer DC, Eggleston JC. Carcinoid tumors of the thymus. Cancer. 1976;37:958–73.
Rao U, Takita H. Carcinoid tumour of possible thymic origin: case report. Thorax. 1977;32:771–6.
Paties C, Zangrandi A, Vasallo G, Rinda G, Solcia E. Multidirectional carcinoma of the thymus with neuroendocrine and sarcomatoid components and carcinoid syndrome. Pathol Res Pract. 1991;187:170–7.
Kuo TT. Carcinoid tumor of the thymus with divergent sarcomatoid differentiation: report of a case with histogenetic considerations. Hum Pathol. 1994;25:319–23.
Mizuno T, Masaoka A, Hashimoto T, Shibata K, Yamakawa Y, Torii K, et al. Coexisting thymic carcinoid tumor and thymoma. Ann Thorac Surg. 1990;50:650–2.
Suster S, Moran CA. Thymic carcinoid with prominent mucinous stroma: report of a distinctive morphologic variant of thymic neuroendocrine neoplasm. Am J Surg Pathol. 1995;19:1277–85.
Moran CA, Suster S. Angiomatoid neuroendocrine carcinoma of the thymus: report of a distinctive morphological variant of neuroendocrine tumor of te thymus resembling a vascular neoplasm. Hum Pathol. 1999;30:635–9.
Lagrange W, Dahm HH, Karstens J, Feichtinger J, Mittermayer C. Melanocytic neuroendocrine carcinoma of the thymus. Cancer. 1987;59:484–8.
Ho FCS, Ho JCI. Pigmented carcinoid tumour of the thymus. Histopathology. 1977;1:363–9.
Klemm KM, Moran CA, Suster S. Pigmented thymic carcinoids: a clinicopathological and immunohistochemical study of two cases. Mod Pathol. 1999;12:946–8.
Moran CA, Suster S. Spindle cell neuroendocrine carcinomas of the thymus: (Spindle cell thymic carcinoid): a clinicopathologic and immunohistochemical study of seven cases. Mod Pathol. 1999;12:587–91.
Levine G, Rosai J. A spindle cell variant of thymic carcinoid tumor. A clinical, histologic, and fine structural study with emphasis on its distinction from spindle cell thymoma. Arch Pathol Lab Med. 1976;100:293–300.
Moran CA, Suster S. Primary neuroendocrine carcinoma (thymic carcinoid) of the thymus with prominent oncocytic features: a clinicopathologic study of 22 cases. Mod Pathol. 2000;13:489–94.
Moran CA, Suster S. Cystic well-differentiated neuroendocrine carcinoma (carcinoid tumor): a clinicopathologic and immunohistochemical study of two cases. Am J Clin Pathol. 2006;126:377–80.
Moran CA, Suster S. Thymic neuroendocrine carcinomas with combined features ranging from well differentiated (Carcinoid) to small cell carcinoma. Am J Clin Pathol. 2000;113:345–50.
Wick MR, Scheithauer BW. Oat cell carcinoma of the thymus. Cancer. 1982;49:1652–7.
Chetty R, Batitang S, Govender D. Large cell neuroendocrine carcinoma of the thymus. Histopathology. 1997;31:274.
Miettinen M. Synpatophysin and neurofilament protein as markers for neuroendocrine tumors. Arch Pathol Lab Med. 1987;111:813–8.
Herbst WM, Kummer W, Hofmann W, Otto H, Heym C. Carcinoid tumors of the thymus: an immunohistochemical study. Cancer. 1987;60:2465–70.
DeLellis RA, Wolfe HJ. Calcitonin in spindle cell thymic carcinoid tumors. Arch Pathol Lab Med. 1976;100:340.
Wick MR, Scheithauer BW, Kovacs K. Neuron-specific enolase in neuroendocrine tumors of the thymus, bronchus, and skin. Am J Clin Pathol. 1983;79:703–7.
Weissferdt A, Tang X, Wistuba II, Moran CA. Comparative immunohistochemical analysis of pulmonary and thymic neuroendocrine carcinomas using PAX8 and TTF1. Mod Pathol. 2013;26:1554–60.
Weissferdt A, Kalhor N, Liu H, Rodriguez J, Fujimoto J, Tang X, et al. Thymic neuroendocrine tumors (paraganglioma and carcinoid tumors): a comparative immunohistochemical study of 46 cases. Hum Pathol. 2014;45:2463–70.
Kujari H, Joensuu H, Klemi P, Asola R, Nordman E. A flow cytometridc analysis of 23 carcinoid tumors. Cancer. 1988;61:2517–20.
Fetissof F, Boivin F, Jobar P, Arbeille-Brassart B, Romet L, Maillet M. Microfilamentous carcinoid of the thymus: correlation of ultratructural study with Grimelius stain. Ultrastruct Pathol. 1982;3:9–15.
Kay S, Willson MA. Ultrastructural studies of an ACTH-secreting thymic tumor. Cancer. 1970 Aug;26(2):445–52.
Moran CA, Rush W, Mena H. Primary spinal paragangliomas: a clinicopathological and immunohistochemical study of 30 cases. Histopathology. 1997;31:167–73.
Moran CA, Albores-Saavedra J, Wenig BM, Mena H. Pigmented Extradrenal paragangliomas: a clinicopathologic and immunohistochemical study of five cases. Cancer. 1997;79:398–402.
Moran CA, Suster S, Fishback N, Koss MN. Mediastinal Paragangliomas: a clinicopathologic and immunohistochemical study of 16 cases. Cancer. 1993;72:2358–64.
Phillips B. Intrathoracic pheochromocytoma. Arch Pathol. 1940;30:916–21.
Lattes R. Nonchromaffin paraganglioma of ganglion nodosum, carotid body, and aortic arch bodies. Cancer. 1950;3:667–94.
Marshall RB, Horn RC. Nonchromaffin paraganglioma: a comparative study. Cancer. 1961;4:779–87.
Green WO, Bassett FH. Extrathoracic pheochromocytoma: report of a case. Am J Clin Pathol. 1965;35(2):142–6.
Tama L, Ellis H, Hodgson CH, Dockerty MB. Chemodectoma of the mediastinum: report on a patient with superior vena caval obstruction treated by a shunt from the right innominate vein to the right atrium. J Thorac Cardiovasc Surg. 1962;43:585–94.
Pachter RM. Mediastinal nonchromaffin paraganglioma: a clinicopathologic study based on eight cases. J Thorac Cardiovasc Surg. 1963;45:152–9.
Enquist RW, Tormey DC, Jenis EH, Warkel RL. Malignant chemodectoma of the superior mediastinum with elevated urinary homovanillic acid. Chest. 1974;66:209–11.
Victor S, Anand KV, Andappan P, Bharathy S, Rao S, Reddy KC. Malignant mediastinal chemodectoma. Chest. 1975;68(4):583–4.
Arom V, Nicoloff DM. Intrathoracic paraganglioma arising from aorticosympathetic paraganglion. Arch Surg. 1976;111:275–9.
Lacquet LK, Moulijn AC, Jongerius CM, Rensing JB. Intrathoracic chemodectoma with multiple localisations. Thorax. 1977;32:203–9.
Olson JL, Salyer WR. Mediastinal paragangliomas (Aortic Body Tumor): a report of four cases and a review of the literature. Cancer. 1978;41:2405–12.
Lack EE, Stillinger RA, Colvin DB, Groves RM, Burnette DG. Aortico-pulmonary paraganglioma: report of a case with ultrastructural study and review of the literature. Cancer. 1979;43:269–78.
Gallivan MVE, Chun B, Rowden G, Lack EE. Intrathoracic paravertebral malignant paraganglioma. Arch Pathol Lab Med. 1980;104:46–51.
Grace MP, Batist G, Grace WR, Gillooley JF. Aorticopulmonary paraganglioma and gastric leiomyoblastoma in a young woman. Am J Med. 1981;70:1288–92.
Evora PRB, Bongiovani HL, Sgarbieri RN, Ribeiro PJ, Pereira LC, Moraes MM, et al. Nonfunctioning paraganglioma of the posterior mediastinum. Scand J Thorac Cardiovasc Surg. 1988;22:295–7.
Odze R, Begin LR. Malignant paraganglioma of the posterior mediastinum: a case report and review of the literature. Cancer. 1990;65:564–9.
Assaf HM, Al-Momen AA, Martin JG. Aorticopulmonary paraganglioma: a case report with immunohistochemical studies and literature review. Arch Pathol Lab Med. 1992;116:1085–7.
Dajee A, Dajee H, Hinrichs S, Lillington G. Pulmonary chondroma, extra-adrenal paraganglioma, and gastric leiomyosarcoma. Carney’s tirad. J Thorac Cardiovasc Surg. 1982;84:377–81.
Plaza JA, Wakely PE, Moran CA, Fletcher CD, Suster S. Sclerosing paraganglioma: report of 19 cases of an unusual variant of neuroendocrine tumor that may be mistaken for an aggressive malignant neoplasm. Am J Surg Pathol. 2006;30:7–12.
Kimani S, Young WF. Hereditary paraganglioma-phechromocytoma syndromes. In: Pagaon RA, et al., editors. GeneReviews [internet]. Seattle: University of Washington, Seattle 1993–2015. 2008 May 21 [updated 2014 Nov 06].
Sato H, Shoji S, Kajiwara H, Itoh J, Osamura RY. A novel mutation (P236S) in the succinate dehydrogenase subunit B gene in a Japanese patient with posterior mediastinal paraganglioma. Endocr Pathol. 2013;24:144–8.
Garibaldi E, Bresciani S, Panaia R, Delmastro E, Malinverni G, Gabriele P. Hereditary paraganglioma syndrome associated with SDHD gene mutations: a patient with multicentric presentation treated with radiotherapy. Case report. Tumori. 2011;97:214–20.
Prodanov T, Havekes B, Nathanson KL, Adams KT, Pacak K. Malignant paraganglioma associated with succinate dehydrogenase subunit B in an 8-year-old child: the age of first screening? Pediatr Nephrol. 2009;24:1239–42.
Ortega PF, Sosa LA, Patel M, Zambrano E. Cystic paraganglioma of the anterior mediastinum. Ann Diagn Pathol. 2010;14:341–6.
Flieder DB, Moran CA, Suster S. Primary alveolar soft part sarcoma of the mediastinum: a clinicopathological and immunohistochemical study of two cases. Histopathology. 1997;31:469–73.
Brewer LA. The occurrence of parathyroid tissue within the thymus: report of four cases. Endocrinology. 1934;18(3):397–408.
Cope O. Surgery of hyperparathyroidism: the occurrence of parathryoids in the anterior mediastinum and the division of the operation into two stages. Ann Surg. 1941;114:706–33.
Bauer W, Federman DD. Hyperparathryoidism epitomized: the case of captain Charles E. Martell. Metabolism. 1962;XI(1 (January)):21–9.
Hardy JD, Snavely JR, Langford HG. Low intrathoracic parathyroid adenoma: large functioning tumor representing fifth parathyroid, opposite eight dorsal vertebra with independent arterial supply and opacified at operation with arteriogram. Ann Surg. 1964;159:310–5.
Nathaniels EK, Nathaniels AM, Wang C. Mediastinal parathyroid tumors: a clinical and pathological study of 84 cases. Ann Surg. 1970;171(2):165–70.
Thacker WC, Wells VH, Hall ER. Parathryoid cyst of the mediastinum. Ann Surg. 1971;174:969–75.
Margolis IB, Wayne R, Organ CH. Parathryoid cysts: functional and mediastinal. Surgery. 1975;77:462–6.
Simkin EP. Hyperparathyroidism associated with a parathyroid cyst: an unusual presentation. Br J Surg. 1976;63:927–8.
Calandra DB, Shah KH, Prinz RA, Sullivan H, Hofmann C, Oslapas R, et al. Parathyroid cyst: a report of eleven cases including two associated with hyperparathyroid crisis. Surgery. 1983;94:887–92.
Ramos-Gabatini A, Mallette LE, Bringhurst FR, Draper MW. Functional mediastinal parathyroid cyst: dynamics of parathyroid hormone secreting during cyst aspirations and surgery. Am J Med. 1985;79:633–9.
Linos DA, Schoretsanitis G, Carvounis E. Parathyroid cysts of the neck and mediastinum. Acta Chir Scand. 1989;155:211–6.
Petri N, Holten I. Parathyroid cyst: report of case in the mediastinum. J Laryngol Otol. 1990;104:56–7.
Downey RJ, Cerfolio RJ, Deschamps C, Grant CS, Pairolero PC. Mediastinal parathyroid cyst. Mayo Clin Proc. 1995;70:946–50.
Gurbuz AT, Peetz ME. Giant mediastinal parathyroid cyst: an unusual cause of hypercalcemic crisis—case report and review of the literature. Surgery. 1996;120:795–800.
Scholz DA, Purnell DC, Woolner LB, Clagett OT. Mediastinal hyperfunctioning parathyroid tumors. Ann Surg. 1973;178:173–8.
Wang C, Mahaffey JE, Axelrod L, Perlman JA. Hyperfunctioning supernumerary parathyroid glands. Surg Gynecol Obstet. 1979;148:711–4.
Russell CF, Edis AJ, Scholz DA, Sheedy PF, van Heerden JA. Mediastinal parathyroid tumors: experience with 38 tumors requiring mediastinotomy for removal. Ann Surg. 1981;193:805–9.
Clark OH. Mediastinal parathyroid tumors. Arch Surg. 1988;123:1096–100.
Conn JM, Goncalves MA, Mansour KA, McGarity WC. The mediastinal parathyroid. Am Surg. 1991;57:62–6.
Roslyn JJ, Gordon HE, Mulder DG. Mediastinal parathyroid adenomas: a cause of persistent hyperparathyroidism. Am Surg. 1983;49:523–7.
Schlinkert RT, Whitaker MD, Argueta R. Resection of select mediastinal parathyroid adenomas through an anterior mediastinotomy. Mayo Clin Proc. 1991;66:1110–3.
Murphy MN, Glennon PG, Diocee MS, Wick MR, Cavers DJ. Nonsecretory parathyroid carcinoma of the mediastinum: light microscopic, immunohistochemical, and ultrastructural features of a case, and review of the literature. Cancer. 1986;58:2468–76.
Kastan DJ, Kottamasu SR, Frame B, Greenwald KA. Carcinoma in a mediastinal fifth parathyroid gland. JAMA. 1987;257(9):1218–9.
Putnam JB, Schantz SP, Pugh WC, Hickey RC, Samaan NA, Garza R, et al. Extended en bloc resection of a primary mediastinal parathyroid carcinoma. Ann Thorac Surg. 1990;50:138–40.
Avramides A, Papamargaritis K, Antoniadis A, Gakis D, Leontsini M. Large parathyroid functioning carcinoma (1,200 g) presenting as substernal goiter. J Endocrinol Investig. 1992;15:39–42.
Kelly MD, Sheridan BF, Farnsworth AE, Palfreeman S. Parathyroid carcinoma in a mediastinal sixth parathyroid gland. Aust N Z J Surg. 1994;64:446–9.
Yoshiike F, Koizumi T, Yoneyama A, Komatu M, Yamaguchi S, Hanaoka M, et al. Thymic squamous cell carcinoma producing parathyroid hormone-related protein and CYFRA 21-1. Intern Med. 2004;43(6):493–5.
Hsiao LT, Chiou TJ, Yu IT, Chen PM. Superior vena cava syndrome and hypercalcaemia in a patient with primary mediastinal B-cell lymphoma secreting parathyroid hormone-related protein. Br J Haematol. 2002;119(1):1.
Moran CA, Suster S. Primary parathyroid tumors of the mediastinum: a clinicopathologic and immunohistochemical study of 17 cases. Am J Clin Pathol. 2005;124:749–54.
Becker FO, Tausk K. Radiologically evident functioning mediastinal parathyroid adenoma. Chest. 1970;58:79–81.
College D, Rohati PK. Mediastinal parathyroid cyst. J Comput Assist Tomogr. 1983;7(1):140–2.
Hargreaves HK, Wright TC. A large functioning parathyroid lipoadenoma found in the posterior mediastinum. Am J Clin Pathol. 1981;76:89–93.
Hajhosseini B, Montazeri V, Hajhosseini L, Nezami N, Beygui RE. Mediastinal goiter: a comprehensive study of 60 consecutive cases with special emphasis on identifying predictors of malignancy and sternotomy. Am J Surg. 2012;203:442–7.
Zapatero J, Baamonde C, Gonzalez F, Orusco E, Gallardo MP, Folque E. Ectopic goiters of the mediastinum: presentation of two cases and review of the literature. Jpn J Surg. 1988;18:105–9.
Raffaelli M, De Crea C, Ronti S, Bellantone R, Lombardi CP. Substernal goiters: incidence, surgical approach, and complications in a tertiary care referral center. Head Neck. 2011;33:1420–5.
Erbil Y, Bozbora A, Barbaros U, Ozarmagan S, Azezli A, Movalilar S. Surgical management of substernal goiters: clilnical experience of 170 cases. Surg Today. 2004;34:732–4.
Gao B, Zhang X, Zhao J, Zhao J, He Y, Wen Y, et al. Surgical treatment of large substernal thyroid goiter: analysis of 12 patients. Int J Clin Exp Med. 2013;6:488–96.
Shasha AR. Substernal goiter: what is in a definition? Surgery. 2010;147:239–40.
Huins CT, Georgalas C, Mehrzad H, Tolley NS. A new classification system for retrosternal goiter based on a systematic review of its complications and management. Int J Surg. 2008;6:71–6.
Barker TA, Daultrey CR, Trotter SE, Kalkat M. Intrathymic primary intrathoracic goiter in a patient with breast malignancy. Ann Thorac Surg. 2012;93:35–6.
Landeta F, Hoffmeier A, Fuchs M, Scheld H, Maintz D, Stypmann J, et al. Ectopic thyroid mass in the heart. Lancet. 2012;379:1762.
Rios A, Rodriguez JM, Canteras M, Galindo PJ, Balsalobre MD, Parrilla P. Risk factors for malignancy in multinodular goiters. EJSO. 2004;30:58–62.
Bellafonte R, Lombardi CP, Bossola M, Fadda G, Salvatori M, Princi P. Posterior mediastinal hyperfunctioning insular thyroid carcinoma. Thorax. 2005;95:358–60.
Nervi M, Iacconi P, Spinelli C, Janni A, Miccoli P. Thyroid carcinoma in intrthoracic goiter. Langenbeck's Arch Surg. 1998;383:383–7.
Oikonomou A, Astrinakis E, Giatromanolaki A, Karros P, Margaritis D, Prassopoulos P. Intrathoracic papillary thyroid carcinoma from occult primary disease. Gen Thorac Cardiovasc Surg. 2014;62:198–201.
Sand J, Pehkonen E, Mattila J, Seppănen S, Salmi J. Pulsating mass at the sternum: a primary carcinoma of ectopic mediastinal thyroid. J Thorac Cardiovasc Surg. 1996;112:833–5.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Kalhor, N., Moran, C. (2019). Neuroendocrine Neoplasms. In: Mediastinal Pathology . Springer, Cham. https://doi.org/10.1007/978-3-319-98980-8_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-98980-8_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98979-2
Online ISBN: 978-3-319-98980-8
eBook Packages: MedicineMedicine (R0)