Abstract
A 67-year-old female was referred to our department because of an anterior mediastinal mass shadow on MRI performed during surveillance of her multiple hepatic hemangiomas. The nodule was 16mm in diameter partially enhanced with contrast enhanced CT scan. The lesion was depicted by the MRI scan as an iso-intensity area in T1WI, a slightly high intensity area in T2WI, and a marked high intensity area in short T1 inversion recovery (STIR), in comparison to muscular tissue. MRI scan also showed multiple high intensity areas in the thoraco-lumbar vertebrae, and each lesion was suspected of hemangioma. Furthermore, multiple skin hemangiomas were seen in the face, neck, truncus, and extremities, and blue rubber bleb nevus syndrome (BRBNS) was suspected based on these findings. Therefore, while we decided to operate on the patient with a suspicion of thymoma, a possibility of thymic hemangioma could not be ruled out. As a consequence of thymectomy, the nodule was pathologically proved thymic hemangioma. Additionally, postoperative gastrointestinal endoscopy and brain MRI pointed out hemangiomas in the esophagus and cerebellum, thus we diagnosed her multiple hemangiomas as BRBNS. There are few reports of BRBNS with thymic hemangioma, and the present case seems to be rare.
