Unique presentation of a giant mediastinal tumor as kyphosis: a case report

Eleftherios D Spartalis,Periklis Tomos,Grigorios Karagkiouzis,Gregory Kouraklis,Petros Konofaos,Theodore Karatzas

doi:10.1186/1752-1947-6-99

Abstract

IntroductionAlthough posture distortion is a common problem in elderly patients, spinal deformity caused by a thymoma has not been previously reported. Thymomas are slowly growing tumors that predominantly cause respiratory symptoms.Case presentationWe report the case of an 83-year-old woman who was admitted with a giant mediastinal mass that had caused progressive spinal distortion and weight loss to our department. The clinical and laboratory investigations that followed revealed one of the largest thymomas ever reported in the medical literature, presenting as a mass lesion placed at the left hemithorax. She underwent complete surgical excision of the tumor via a median sternotomy. Two years after the operation, she showed significant improvement in her posture, no pulmonary discomfort, and a gain of 20 kg; she remains disease free based on radiographic investigations.ConclusionsIn this case, a chronic asymmetric load on the spine resulted in an abnormal vertebral curvature deformity that presented as kyphosis.

Highlights

Posture distortion is a common problem in elderly patients, spinal deformity caused by a thymoma has not been previously reported
In this case, a chronic asymmetric load on the spine resulted in an abnormal vertebral curvature deformity that presented as kyphosis
Kyphosis in an adult with no previous history of any spinal curvature deformity should be considered as a possible symptom of an intrathoracic tumor

Summary

Introduction

Thymomas are rare neoplasms with a largely indolent growth pattern and various clinical symptoms [1]. Posteroanterior and lateral chest radiographs (Figures 1a and 1b) demonstrated a mediastinal homogenous opacity partially filling the left hemithorax and causing tracheal displacement. She was referred to our department for further investigation. A physical examination revealed marked prominence of the left hemithorax. This region was dull to percussion and did not move with respiration. The patient subsequently underwent radical surgical excision of the tumor (Figure 3) via median sternotomy. Follow-up CT scans revealed no evidence of disease (Figure 2b) Her trachea and esophagus were returned to their anatomical location, the lungs were fully expanded and the mediastinum had returned to its normal width

Discussion

Conclusions