Shogo Yobita1, Shuhei Iizuka2, Yoshiro Otsuki3, Toru Nakamura4. 1. Departments of General Thoracic Surgery and Pathology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka, 430-8558, Japan. Electronic address: yobisyou@gmail.com. 2. Departments of General Thoracic Surgery and Pathology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka, 430-8558, Japan. Electronic address: shue@dc4.so-net.ne.jp. 3. Departments of General Thoracic Surgery and Pathology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka, 430-8558, Japan. Electronic address: otsuki@sis.seirei.or.jp. 4. Departments of General Thoracic Surgery and Pathology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Nakaku, Hamamatsu-city, Shizuoka, 430-8558, Japan. Electronic address: tonakamu@nifty.ne.jp.
Abstract
INTRODUCTION AND IMPORTANCE: Mediastinal hemangiomas are a rare entity frequently developing in the anterior mediastinum. They may exhibit an infiltrating appearance into the surrounding tissue, and extensive surgery is often required despite its benign nature. We report a case of a mediastinal hemangioma mimicking an invasive tumor growth requiring a combined resection of the lung and diaphragm. CASE PRESENTATION: An asymptomatic 73 year-old-man presented with a 50 mm-sized mass on his chest radiography. A combined resection of the mediastinal mass with the part of the lower lobe of left lung and diaphragm not necessitating a patch repair was performed. The pathological findings were compatible with a diagnosis of a mediastinal hemangioma. Only fibrous adhesions were observed between the tumor and resected lung and diaphragm without any histological invasion. CLINICAL DISCUSSION: While imaging examinations play a key role in determining a preoperative diagnosis, mediastinal hemangiomas may pose a diagnostic challenge mainly due to its rarity. With a clinical suspicion of a hemangioma during the diagnostic work up, a dynamic CT might be helpful. CONCLUSIONS: In mediastinal hemangiomas, a preoperative diagnosis is essential in order to avoid extensive surgery. A hemangioma should be raised as a differential diagnosis for anterior mediastinal tumors, especially in cases with an infiltrative appearance that suggests the necessity for a combined resection of the surrounding organs.
INTRODUCTION AND IMPORTANCE: Mediastinal hemangiomas are a rare entity frequently developing in the anterior mediastinum. They may exhibit an infiltrating appearance into the surrounding tissue, and extensive surgery is often required despite its benign nature. We report a case of a mediastinal hemangioma mimicking an invasive tumor growth requiring a combined resection of the lung and diaphragm. CASE PRESENTATION: An asymptomatic 73 year-old-man presented with a 50 mm-sized mass on his chest radiography. A combined resection of the mediastinal mass with the part of the lower lobe of left lung and diaphragm not necessitating a patch repair was performed. The pathological findings were compatible with a diagnosis of a mediastinal hemangioma. Only fibrous adhesions were observed between the tumor and resected lung and diaphragm without any histological invasion. CLINICAL DISCUSSION: While imaging examinations play a key role in determining a preoperative diagnosis, mediastinal hemangiomas may pose a diagnostic challenge mainly due to its rarity. With a clinical suspicion of a hemangioma during the diagnostic work up, a dynamic CT might be helpful. CONCLUSIONS: In mediastinal hemangiomas, a preoperative diagnosis is essential in order to avoid extensive surgery. A hemangioma should be raised as a differential diagnosis for anterior mediastinal tumors, especially in cases with an infiltrative appearance that suggests the necessity for a combined resection of the surrounding organs.