Malignant triton tumor of the left thoracic cavity: a case r
Malignant triton tumor (MTT) is a rare subtype of malignant peripheral nerve sheath tumors (MPNSTs) showing rhabdomyosarcomatous differentiation. MTTs account for < 10% of MPNSTs and exhibit an aggressive course of disease.

A 64-year-old male with a 92-pack/year smoking history was admitted to the emergency department of the institution with sudden shortness of breath. Chest X-ray and computed tomography on admission revealed the presence of massive left pleural effusion and a large tumor (diameter: 13 cm) occupying the patient’s left thoracic cavity (Fig. 1). Pleural effusion cytology and a bronchofiberscopic study failed to show any evidence of disease. Under local anesthesia, percutaneous needle biopsy performed through the left thoracic wall revealed the presence of a sarcomatous lesion and positive immunohistochemical staining for CD56 and desmin. Based on these findings, the diagnosis of MTT was considered. There was no evidence of distant metastases.

The diagnosis of MTT is based on pathological examination. The basic histological presentation is atypical spindle cell proliferation embedded in an abundant myxoid stroma. Demonstrating the bigeminal origin is the mainstay for accurate diagnosis. Intriguingly, in the present case, needle biopsy led to the definitive diagnosis of MTT.

Source: Journal of Surgical Case Reports

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