Left Paravertebral Mass Research Articles

Paraganglioma in the posterior mediastinum: a case report

BackgroundParagangliomas are tumors that arise from extra-adrenal chromaffin cells. Herein, we present a rare case of a functional paraganglioma in the posterior mediastinum.Case presentationA 36-year-old man presented with paroxysms of chest pain and headache. At presentation, the patient’s blood pressure was 190/120 mmHg. Chest computed tomography and magnetic resonance imaging revealed a left paravertebral mass in the posterior mediastinum. 123I-metaiodobenzylguanidine scanning revealed focally high tracer uptake in the left paravertebral area. The metanephrine level in the urine was elevated, confirming a rare, catecholamine-producing, functional paraganglioma in the posterior mediastinum. Before surgery, the patient was prepared by orally administering α- and β-adrenergic blockers. The mass was then resected via a lateral thoracotomy. The metanephrine level in urine was normal 24 h after surgery.ConclusionsParagangliomas in the posterior mediastinum are very rare, but more than half of all cases are functional. The associated symptoms are curable with complete resection, and long-term follow-up for recurrence is important.

A Paravertebral Pulsatile Mass

A 46-year–old man was admitted for severe back pain over the interscapular area radiating anteriorly along the ribs. Symptoms started intermittently 2 months previously, but became severe and persistent over the past 3 days. The patient was a former sailor and a heavy smoker, with no relevant personal or family history of cardiovascular disease. At physical examination, a pulsatile left paravertebral mass could be seen and palpated close to the spine (online-only Data Supplement Movie I). A high-pitched descrescendo diastolic murmur could be heard along the left sternal border. He was normotensive and tachycardic, with no signs of pulmonary or systemic congestion. The ECG showed sinus tachycardia (115 beats per minute) and complete right bundle-branch block with secondary ST-T …

Soft tissue Rosai-Dorfman disease of the posterior mediastinum

Rosai-Dorfman disease (RDD) consists of sinus histiocytosis with massive lymphadenopathy. Extranodal involvement occurs in up to 43% of cases. However, isolated soft tissue RDD is rare. Isolated mediastinal RDD is exceedingly rare, and there have been only three previous reports. Involvement of the posterior mediastinum in RDD has been reported only in the context of disseminated RDD. Here, we report the case of a 49-year-old female patient with a two-year history of cervical pain and lymphadenomegaly, which resolved spontaneously. A CT scan revealed a left paravertebral mass with a diameter of 6 cm. The patient was submitted to surgical excision of the mass. Microscopic examination and immunophenotyping of the surgical specimen led to a diagnosis of RDD. During a 12-month follow-up period, the patient complained of mild cough and chest pain. Periodic imaging tests showed no sign of recurrence, and no postoperative cervical lymphadenomegaly was detected.

Myxopapillary ependymoma of the posterior mediastinum

A left paravertebral mass discovered incidentally on routine examination in a 39-year-old woman is described. Computerized tomography studies revealed a 7 x 6 cm, well circumscribed, noncalcified soft tissue mass with lobular borders abutting the left inferior pulmonary vein and descending aorta. It was not possible to determine the exact anatomic location of the mass based on the imaging studies as both peripheral lung tumors and posterior mediastinal lesions may exhibit the imaging findings described here. At thoracotomy, the mass was seen to be well circumscribed, focally attached to the pleura but without involvement of lung parenchyma, and situated in the left posterior mediastinum. On histological examination, the lesion showed the classical features of myxopapillary ependymoma. Immunohistochemical studies confirmed this impression by demonstrating strong positivity of the tumor cells for S-100 protein, glial fibrillary acidic protein, and CD99 and negative staining with other differentiation markers. A review of the literature with a discussion of the histologic and radiologic differential diagnosis of these lesions is presented.

A benign leiomyoma causing paraparesis: a case report and histopathogenesis

A benign leiomyoma causing paraparesis: a case report and histopathogenesis

Intrathoracic Mass in a Young Woman With Skin Lesions

History A 31-year-old woman was hospitalized for further evaluation of a mass that was discovered on a chest roentgenogram taken because of an upper respiratory tract infection. Physical examination revealed several cafe-aulait spots over the skin. Kyphoscoliosis of the midthoracic vertebrae with posterior scalloping of some of the vertebral bodies was also noted. The admission posteroanterior chest film is shown in Fig 1. A well-defined left paravertebral soft-tissue mass density measured about 6 cm in diameter. Figure 2 is an anteroposterior tomogram of the dorsal spine. Diagnosis Lateral intrathoracic meningocele in a patient with neurofibromatosis. Figures 1 and 2 show a large left paravertebral mass with scalloping of the left side of the bodies of D7 to D9. The possibility of neurofibromatosis with an intrathoracic meningocele was suspected from the patient's physical examination and roentgen findings. This was confirmed by myelography (Fig 3), which showed contrast material filling the masslike