Persistent wheezing as manifestation of esophageal tubular duplication cyst

Duplications of esophagus are rare congenital anomalies and the second most common duplications of the gastrointestinal tract. This form of bronchopulmonary foregut malformation may appear as a cystic mediastinal mass. On chest radiographs they may be visible as middle or posterior masses. On CT they are well marginated and oppose the esophagus. Usually they are asymptomatic, unless they become infected or cause obstruction. We report a case of thoracic tubular duplication cyst in a 10-month-old boy who presented with persistent wheezing that was unsuccessfully treated in out-patient services

Challenges in the prenatal and post-natal diagnosis of mediastinal cystic hygroma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cystic hygroma is a benign congenital neoplasm that mostly presents as a soft-tissue mass in the posterior triangle of the neck. Pure mediastinal lesions are uncommon; the vast majority are asymptomatic and are an incidental finding in adulthood. The diagnosis is often made intra- or postoperatively. Prenatal identification is exceptional and post-natal diagnosis also proves challenging.</p> <p>Case presentation</p> <p>We report one such case that was mistaken for other entities in both the prenatal and immediate post-natal period. Initial and follow-up antenatal ultrasound scans demonstrated a multicystic lesion in the left chest, and the mother was counselled about the possibility of her baby having a congenital diaphragmatic hernia. Initial post-natal chest radiographs were reported as normal. An echocardiogram and thoracic computed tomography scan confirmed a complex multiloculated cystic mediastinal mass. The working diagnoses were of a mediastinal teratoma or congenital cystic adenomatous malformation. At operation, the lesion was compressed by the left lung and was found to be close to the left phrenic nerve, which was carefully identified and preserved. After excision, histopathological examination of the mass confirmed the diagnosis of cystic hygroma. Postoperative dyspnoea was observed secondary to paradoxical movement of the left hemidiaphragm and probable left phrenic neuropraxia. This settled conservatively with excellent recovery.</p> <p>Conclusion</p> <p>Despite the fact that isolated intrathoracic cystic hygroma is a rare entity, it needs to be considered in the differential diagnosis of foetal and neonatal mediastinal masses, particularly for juxtadiaphragmatic lesions. The phrenic nerve is not identifiable on prenatal ultrasound imaging, and it is therefore understandable that a mass close to the diaphragm may be mistaken for a congenital diaphragmatic hernia because of the location, morphology and potential phrenic nerve compression. Post-natal diagnosis may also be misleading as many mediastinal cystic masses have similar appearances on imaging. Therefore, as well as cystic architecture, special consideration needs to be given to the anatomical location and effect on local structures.</p

A Huge Mediastinal Organizing Hematoma Causing Reversal of Atrial Septal Defect Shunt Flow

We report a case of a 46-year-old woman who presented with subacute exertional dyspnea and severe hypoxia. A large cystic mass compressing the right side of the heart along with right-to-left atrial shunt flow through an alleged atrial septal defect (ASD) were detected on echocardiography. CT scan of the chest and MRI of the heart revealed a loculated cystic mediastinal mass with hemorrhage measuring 5.5×8 cm compressing the right atrium and ventricle. The patient underwent cyst resection and primary closure of the ASD. This report illustrates a case of an unusual symptomatic pericardial mass compressing the right atrium and ventricle in a patient with an secundum ASD

Cystic thymoma presenting with urticaria: a case report

Thymomas are epithelial neoplasms of the thymus and are the most common primary tumors of the anterior superior mediastinum, although it can also arise in other locations like the neck, the middle or posterior mediastinum, the lung and the pleural cavity. Ectopic thymomas are said to arise from scattered thymic elements as a result of failure of migration into the anterosuperior mediastinum. The neoplasm may be well encapsulated or may display varying degrees of invasion of the tumor capsule and the adjacent structures. We report a case of non-invasive cystic thymoma in a young individual with unusual clinical presentation and imaging findings

Prenatal ultrasonographic diagnosis and successful management of mediastinal teratoma A case report

A case of mediastinal teratoma, diagnosed in utero by realtime ultrasonography during a late 3rd trimester evaluation of polyhydramnios, is described. Prompt respiratory assistance to the infant at birth and early surgical intervention led to a successful outcome

Case report: Epidermoid cyst misdiagnosed as a loculated pericardial effusion

A 25-year old man presented with a mediastinal lesion which was initially diagnosed as a loculated pericardial collection on echocardiography. Subsequent imaging showed it to be a cystic mediastinal mass, and following surgery and histopathology, it turned out to be an epidermoid cyst

Traveling from uveitis to thyroidectomy via the mediastinum

Cystic mediastinal masses are most commonly benign congenital lesions. Rarely, a cystic mediastinal mass will prove to be malignant. The patient, a 50-year-old woman who initially presented with uveitis, was incidentally found to have a right paratracheal opacity on chest X-ray (CXR). Chest computed tomography (CT) demonstrated a 5cm right paratracheal hypodense cystic mass. The patient underwent a right robotic-assisted thoracoscopic resection of the mediastinal mass. Final pathology revealed a 4.5cm mass consistent with metastatic papillary thyroid carcinoma (similar histology in 2 excised lymph nodes). The patient subsequently had a total thyroidectomy with central and right neck dissections