Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: Case report and literature review

Filippo Alongi, Angelo Bolognesi, A. M S Gajate, Micaela Motta, Claudio Landoni, Genoveffa Berardi, Pierpaolo Alongi, Luigi Gianolli, Nadia Di Muzio

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Mediastinal inflammatory pseudotumor is a rare disease with reactive pseudoneo-plastic features and a proven capacity for local invasion. The radiographic appearance of inflammatory pseudotumor is quite non-specific and the definitive diagnosis is based on the histological evaluation of tissue specimens. Resection of the lesion is the treatment of choice. However, nonsurgical treatments such as radiotherapy and steroids have been employed in the setting of incomplete surgical resection, tumor recurrence, and patients being unfit for surgery. The case described here is being reported because of the rare mediastinal location and atypical treatment approach including salvage irradiation and monitoring with FDG-PET/CT. Because of the irregular target volume inside the mediastinum as defined by FDG-PET/CT and the significant pulmonary comorbidity, it was deemed necessary to optimize dose delivery with intensity-modulated radiation therapy (IMRT). A possible gain by means of daily control of patient setup with image-guided radiation therapy was also hypothesized and we used tomotherapy to irradiate the lesion. The first FDG-PET/CT after treatment confirmed further reduction of the metabolic activity followed by stable disease in themediastinum, with no new occurrence of disease 16, 24 and 30 months after tomotherapy.

Original languageEnglish
Pages (from-to)322-326
Number of pages5
JournalTumori
Volume96
Issue number2
Publication statusPublished - Mar 2010

Fingerprint

Plasma Cell Granuloma
Mediastinum
Radiotherapy
Image-Guided Radiotherapy
Therapeutics
Rare Diseases
Plastics
Comorbidity
Steroids
Recurrence
Lung
Neoplasms

Keywords

  • Inflammatory pseudotumor
  • Mediastinum
  • PET/CT
  • Tomotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Alongi, F., Bolognesi, A., Gajate, A. M. S., Motta, M., Landoni, C., Berardi, G., ... Di Muzio, N. (2010). Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: Case report and literature review. Tumori, 96(2), 322-326.

Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT : Case report and literature review. / Alongi, Filippo; Bolognesi, Angelo; Gajate, A. M S; Motta, Micaela; Landoni, Claudio; Berardi, Genoveffa; Alongi, Pierpaolo; Gianolli, Luigi; Di Muzio, Nadia.

In: Tumori, Vol. 96, No. 2, 03.2010, p. 322-326.

Research output: Contribution to journalArticle

Alongi, F, Bolognesi, A, Gajate, AMS, Motta, M, Landoni, C, Berardi, G, Alongi, P, Gianolli, L & Di Muzio, N 2010, 'Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: Case report and literature review', Tumori, vol. 96, no. 2, pp. 322-326.
Alongi F, Bolognesi A, Gajate AMS, Motta M, Landoni C, Berardi G et al. Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: Case report and literature review. Tumori. 2010 Mar;96(2):322-326.
Alongi, Filippo ; Bolognesi, Angelo ; Gajate, A. M S ; Motta, Micaela ; Landoni, Claudio ; Berardi, Genoveffa ; Alongi, Pierpaolo ; Gianolli, Luigi ; Di Muzio, Nadia. / Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT : Case report and literature review. In: Tumori. 2010 ; Vol. 96, No. 2. pp. 322-326.
@article{0355ea354fd04a18b3a95d8e50226e25,
title = "Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: Case report and literature review",
abstract = "Mediastinal inflammatory pseudotumor is a rare disease with reactive pseudoneo-plastic features and a proven capacity for local invasion. The radiographic appearance of inflammatory pseudotumor is quite non-specific and the definitive diagnosis is based on the histological evaluation of tissue specimens. Resection of the lesion is the treatment of choice. However, nonsurgical treatments such as radiotherapy and steroids have been employed in the setting of incomplete surgical resection, tumor recurrence, and patients being unfit for surgery. The case described here is being reported because of the rare mediastinal location and atypical treatment approach including salvage irradiation and monitoring with FDG-PET/CT. Because of the irregular target volume inside the mediastinum as defined by FDG-PET/CT and the significant pulmonary comorbidity, it was deemed necessary to optimize dose delivery with intensity-modulated radiation therapy (IMRT). A possible gain by means of daily control of patient setup with image-guided radiation therapy was also hypothesized and we used tomotherapy to irradiate the lesion. The first FDG-PET/CT after treatment confirmed further reduction of the metabolic activity followed by stable disease in themediastinum, with no new occurrence of disease 16, 24 and 30 months after tomotherapy.",
keywords = "Inflammatory pseudotumor, Mediastinum, PET/CT, Tomotherapy",
author = "Filippo Alongi and Angelo Bolognesi and Gajate, {A. M S} and Micaela Motta and Claudio Landoni and Genoveffa Berardi and Pierpaolo Alongi and Luigi Gianolli and {Di Muzio}, Nadia",
year = "2010",
month = "3",
language = "English",
volume = "96",
pages = "322--326",
journal = "Tumori",
issn = "0300-8916",
publisher = "SAGE Publications Ltd",
number = "2",

}

TY - JOUR

T1 - Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT

T2 - Case report and literature review

AU - Alongi, Filippo

AU - Bolognesi, Angelo

AU - Gajate, A. M S

AU - Motta, Micaela

AU - Landoni, Claudio

AU - Berardi, Genoveffa

AU - Alongi, Pierpaolo

AU - Gianolli, Luigi

AU - Di Muzio, Nadia

PY - 2010/3

Y1 - 2010/3

N2 - Mediastinal inflammatory pseudotumor is a rare disease with reactive pseudoneo-plastic features and a proven capacity for local invasion. The radiographic appearance of inflammatory pseudotumor is quite non-specific and the definitive diagnosis is based on the histological evaluation of tissue specimens. Resection of the lesion is the treatment of choice. However, nonsurgical treatments such as radiotherapy and steroids have been employed in the setting of incomplete surgical resection, tumor recurrence, and patients being unfit for surgery. The case described here is being reported because of the rare mediastinal location and atypical treatment approach including salvage irradiation and monitoring with FDG-PET/CT. Because of the irregular target volume inside the mediastinum as defined by FDG-PET/CT and the significant pulmonary comorbidity, it was deemed necessary to optimize dose delivery with intensity-modulated radiation therapy (IMRT). A possible gain by means of daily control of patient setup with image-guided radiation therapy was also hypothesized and we used tomotherapy to irradiate the lesion. The first FDG-PET/CT after treatment confirmed further reduction of the metabolic activity followed by stable disease in themediastinum, with no new occurrence of disease 16, 24 and 30 months after tomotherapy.

AB - Mediastinal inflammatory pseudotumor is a rare disease with reactive pseudoneo-plastic features and a proven capacity for local invasion. The radiographic appearance of inflammatory pseudotumor is quite non-specific and the definitive diagnosis is based on the histological evaluation of tissue specimens. Resection of the lesion is the treatment of choice. However, nonsurgical treatments such as radiotherapy and steroids have been employed in the setting of incomplete surgical resection, tumor recurrence, and patients being unfit for surgery. The case described here is being reported because of the rare mediastinal location and atypical treatment approach including salvage irradiation and monitoring with FDG-PET/CT. Because of the irregular target volume inside the mediastinum as defined by FDG-PET/CT and the significant pulmonary comorbidity, it was deemed necessary to optimize dose delivery with intensity-modulated radiation therapy (IMRT). A possible gain by means of daily control of patient setup with image-guided radiation therapy was also hypothesized and we used tomotherapy to irradiate the lesion. The first FDG-PET/CT after treatment confirmed further reduction of the metabolic activity followed by stable disease in themediastinum, with no new occurrence of disease 16, 24 and 30 months after tomotherapy.

KW - Inflammatory pseudotumor

KW - Mediastinum

KW - PET/CT

KW - Tomotherapy

UR - http://www.scopus.com/inward/record.url?scp=77952925200&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952925200&partnerID=8YFLogxK

M3 - Article

C2 - 20572593

AN - SCOPUS:77952925200

VL - 96

SP - 322

EP - 326

JO - Tumori

JF - Tumori

SN - 0300-8916

IS - 2

ER -