Anterior Mediastinal Mass

Abstract

(Chest 1993; 103:1577-78) A 41-year-old woman presented with a 3-month history ofright anterior chest pain. PA and lateral chest radiographs showed a smooth, well-defined 8cm anterior mediastinal mass. No contained calcification was present (Fig 1). Computed tomography (CT) of the thorax with bolus injection of contrast material revealed multiple punctate calcifications in the mass, which spanned the anterior and middle mediastinum (Fig 2, left). Pooling of the contrast occurred on the later scans (Fig 2, right). Further history revealed that the patient was a lifetime nonsmoker. There was flO history of dyspnea, hemoptysis, cough, voice change, difficulty in swallowing, fever, weight loss, or sensory or motor abnormalities in the upper extremities. Physical examination revealed normal vital signs. There was fl() clubbing, cyanosis, or edema. Examination of the neck revealed flO lymphadenopathy or thyroid enlargement. Excursion of the chest was normal. There were no rubs, crackles, or wheezes. Laboratory investigations revealed a hemoglobin level of 13.4 mmIL, a WBC count of 8.7 x 10”/L and a platelet count of 212,000/mm3. Oxygen saturation on room air was 97 percent. The patient was taken to the operating room, and the tumor was removed through a midline sternotomy without complication. Pathologic examination revealed