Herein, we report a case of surgically treated idiopathic fibrosing mediastinitis. A 32-year-old man has an unknown fever. Several medications, including prednisolone, failed to improve his symptoms. (18)F-fluorodeoxyglucose positron emission tomography/computed tomography revealed the abnormal accumulation of the mediastinal and left neck lymph nodes. A definite diagnosis could not be obtained despite an incisional biopsy of the left neck lymph node. We performed robot-assisted thoracic surgery resection of the mediastinal lesion. The pathological diagnosis was idiopathic fibrosing mediastinitis. After surgical treatment, significant clinical improvements were observed. Few reports showed the effect of surgery on idiopathic fibrosing mediastinitis patients with non-compressive symptoms.
References
[1]
Rossi, G.M., Emmi, G., Corradi, D., Urban, M.L., Maritati, F., Landini, F., et al. (2016) Idiopathic Mediastinal Fibrosis: A Systemic Immune-Mediated Disorder. A Case Series and a Review of the Literature. ClinicalReviewsinAllergy&Immunology, 52, 446-459. https://doi.org/10.1007/s12016-016-8584-1
Kobayashi, Y., Ishiguro, T., Takaku, Y., Kagiyama, N., Shimizu, Y. and Takayanagi, N. (2021) Clinical Features of Fibrosing Mediastinitis in Japanese Patients: Two Case Reports and a Literature Review. InternalMedicine, 60, 3765-3772. https://doi.org/10.2169/internalmedicine.5737-20
[4]
Mathisen, D.J. and Grillo, H.C. (1992) Clinical Manifestation of Mediastinal Fibrosis and Histoplasmosis. TheAnnalsofThoracicSurgery, 54, 1053-1058. https://doi.org/10.1016/0003-4975(92)90069-g
[5]
Park, J.H., Lucaj, J. and Denchev, K.L. (2022) Fibrosing Mediastinitis Presenting with Superior Vena Cava Syndrome. Cureus, 14, e23700. https://doi.org/10.7759/cureus.23700
[6]
Pujitha, V., Pandey, N.N., Arvind, B. and Kumar, S. (2022) Idiopathic Focal Fibrosing Mediastinitis with Unilateral Pulmonary Arterial and Venous Involvement. JournalofCardiacSurgery, 37, 5466-5467. https://doi.org/10.1111/jocs.17182
[7]
Inoue, M., Nose, N., Nishikawa, H., Takahashi, M., Zen, Y. and Kawaguchi, M. (2007) Successful Treatment of Sclerosing Mediastinitis with a High Serum IgG4 Level. GeneralThoracicandCardiovascularSurgery, 55, 431-433. https://doi.org/10.1007/s11748-007-0154-2
[8]
Sfyridis, P., Shatelen, N. and Kalangos, A. (2021) Vascular Homografts as Bypass Grafts for Superior Vena Cava Syndrome Due to Idiopathic Fibrosing Mediastinitis. JournalofVascularSurgeryCases, InnovationsandTechniques, 7, 335-338. https://doi.org/10.1016/j.jvscit.2021.03.013
[9]
Guerrero, A., Karmy-Jones, R., Hoffer, E.K., Hudson, L. and Schuler, P. (2001) Treatment of Pulmonary Artery Compression Due to Fibrous Mediastinitis with Endovascular Stent Placement. CHEST, 119, 966-968. https://doi.org/10.1378/chest.119.3.966
