Cases presented in October 2017
CASE 1: A 72-year-old woman presented to the Emergency Department after a fall complaining of bilateral leg weakness. She had polio as a child, but no other contributing history. On physical examination her vital signs were normal as well as her neurological examination. She had normal reflexes, no neurological deficits, and no leg weakness.
As part of the routine investigation, a chest radiograph was obtained which demonstrated a prevascular mass abutting and inseparable from the right heart border (Figure 1A). To further investigate this mass, a contrast-enhanced chest CT scan (Figure 1B) was obtained followed by a chest MRI (Figure 1C,D). Upon review of the images the tumor board radiologist described the mass as a homogenous fluid density prevascular mass, most suggestive of a benign cyst.
CASE 2. As part of his routine medical check-up, a 51-year-old asymptomatic marathon runner had a chest radiograph, which revealed a mediastinal mass. His physical examination was normal. Four years before that he had had pericarditis which was diagnosed by clinical symptomatology and echocardiography, presumed to be of viral etiology, and the patient recovered with non-steroidal anti-inflammatory medication.
Following the chest radiograph, the patient had a chest CT, chest MRI, and whole body FDG PET-CT that were reviewed by the diagnostic radiologist on the tumor board. The chest CT demonstrates a prevascular soft tissue mass (Figure 2A) which abuts the right atrium.
Sigurdson S, Marom EM, Roden AC, Detterbeck FC, Falkson CB. Case presentations and recommendations from the October 2017 ITMIG tumor board: an international multidisciplinary team. Mediastinum 2018;2:53.