Posterior Mediastinal Mass
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A 30-year-old man presented with chest pressure, shortness of breath, severe dyspnea on exertion, dysphagia, odynophagia and a weight loss of 30 lb (14 kg) over a 2-month period. He had undergone orchiectomy 3 years earlier for stage 1 testicular seminoma but had been lost to follow-up. Cardiac examination revealed normal sinus rhythm without murmurs or gallops, and the lungs were clear on auscultation. Radiography (Panel A) and computed tomography(Panel B) of the chest revealed a large, posterior mediastinal mass. On CT, the mass measured 19 cm by 15 cm by 8 cm, displaced adjacent structures and circumscribed the descending thoracic aorta. Laboratory evaluation revealed a human chorionic gonadotropin level of 4 mIU per milliliter, a lactate dehydrogenase level of 1400 U per liter and a normal alpha-fetoprotein level. Findings on biopsy were consistent with seminoma.The patient received three cycles of chemotherapy with bleomycin, etoposide and cisplatin, with substantial improvement in his symptoms. A follow-up CT scan 3 months later (Panel C) revealed a marked decrease in the size of the mass...

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Dr. P●●●●●t j●a Radiology
Good presentation
Jul 10, 2017Like