2019 Volume 35 Issue 2 Pages 126-132
The patient was an 11-year-old girl. At the age of 8 years, a chest radiograph showed a tumor shadow. CT revealed a 44 × 32-mm-sized tumor extending from the anterior mediastinum’s right side to the right-side rim of the heart. The boundary with the surrounding tissue was clear, calcification was not observed, and no clear contrast effect was observed. On MRI, there was intermediate signal in the T1-weighted image (WI) and mixed low-to-high signal in the T2-WI. No obvious fat component was observed. Angiography revealed blood flowing from the right internal thoracic artery to the mass and multiple outflowing blood vessels to the superior vena cava. There was no significant increase in 18F-FDG accumulation on PET. Based on these findings, the tumor was deemed asymptomatic, and a follow-up policy was selected, considering extralobar sequestration first. However, CT examination at 11 years of age showed that the tumor had increased in size, at 67 × 49 mm, and superior vena caval exclusion was observed, while MRI showed a cystic structure exhibiting high signal on T1- and T2-WI inside. Surgery for extrapulmonary lung fractionation and excision was decided on. The operation involved median sternotomy and anterior mediastinal tumor extirpation (thymic complication excision). The pathological diagnosis was thymic angiolipoma, without malignant findings.
