A 79-YEAR-OLD MAN came to our emergency department and asked that we check on a mediastinal mass that was first detected on a routine chest film 3 years earlier. The patient was asymptomatic; his medical history was unremarkable except for vitamin B12 deficiency. Physical examination revealed no abnormalities except for minor ataxia that was attributed to the lack of sufficient vitamin B12. A chest radiograph (FIGURE 1A) revealed a mass located in the upper right thorax with a slight deviation of the trachea to the left, consistent with previous x-ray findings. A computed tomography (CT) scan of the thorax (FIGURE 1B) showed a heterogeneous, multinodular mass in the anterior mediastinum with a maximal longitudinal diameter of 13.5 cm and a diagonal diameter of 9 cm. There was no obstruction or invasion of the trachea, esophagus, or mediastinal vessels.
FIGURE 1
X-ray and CT point to a diagnosis
The patient’s x-ray (A) revealed a mass in the upper right thorax with slight deviation of the trachea to the left (arrow). A CT scan of the thorax (B) revealed a heterogeneous, multinodular mass in the anterior mediastinum (asterisk). The mass did not obstruct or invade the trachea, esophagus, or mediastinal vessels.
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